Preamble

The House met at half-past Two o'clock

PRAYERS

[MR. SPEAKER in the Chair]

PRIVATE BUSINESS

ASSOCIATED BRITISH PORTS (HULL) BILL

Lords amendments agreed to.

CITY OF LONDON (VARIOUS POWERS) BILL

Order for consideration, as amended, read.

To be considered tomorrow.

HAYLE HARBOUR BILL [Lords] (By Order)

QUEEN MARY AND WESTFIELD COLLEGE BILL [Lords] (By Order)

Orders for consideration, as amended, read.

To be considered tomorrow.

Oral Answers to Questions — HEALTH

Nurses (Grading)

Mr. Ernie Ross: To ask the Secretary of State for Health if he will make a statement on the progress of appeals by nurses with regard to regradings.

The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman): The grading appeals are being dealt with under a longstanding agreement between the management and staff sides of the general Whitley council on procedures for settling differences over NHS employees' conditions of service.
Detailed arrangements for operating this agreement are for local decision.

Mr. Ross: The Under-Secretary will know that today a large delegation of Confederation of Health Service Employees nurses attended the Scottish Grand Committee, which was discussing health. Many of those nurses are still awaiting their gradings which were originally given on 31 October 1988. Can the Minister give the House a guarantee that those appeals will be heard by 31 October 1989?

Mr. Freeman: No, I cannot give that assurance. It is for local health authorities to hold those appeals as expeditiously as possible. I should point out to the hon. Gentleman that the unions, including COHSE, agreed the procedure for grading appeals. We are following that procedure, which involves three tiers, to the letter.

Mr. Holt: Will my hon. Friend take it from me that, whatever scheme is in operation, the midwives in south

Teesside, who have been given one of the most magnificent hospitals in the country, are thoroughly fed up at having to wait for their claims to be heard? What will the Government do, apart from sitting back and saying that it is in someone else's hands?

Mr. Freeman: The local health authority will be pursuing those appeals as expeditiously as possible. Midwives have enjoyed an increase in salary over the past two years of 28 per cent. on average. The concern is not about pay, it is about other conditions of service. The midwives have had an excellent pay increase and appeals will he heard as quickly as possible.

Mr. Fearn: Is the Minister aware that at the midwives' conference that I attended last week, and which he could not attend the night before, but attended the following day, morale was very low? That was because the grading system still has not satisfied any group of midwives. Can the Minister tell the midwives that perhaps in the next six months they will have a satisfactory answer to the grading system?

Mr. Freeman: Ninety per cent. of all staff midwives are on grade E and higher. They have had a remarkably successful outcome from the regrading exercise and the pay increases.

Mr. Robin Cook: I appreciate that this was before the Minister's time at the Department of Health, but does he recall the Secretary of State lecturing nurses last summer that if they were dissatisfied with their grades they should appeal? As they encouraged nurses to appeal as the remedy, Ministers cannot now wash their hands of the shortcomings of the appeals system. Is he aware that tens of thousands of appeals at district level will not be heard until the end of next year and that 2,000 appeals at regional level will not be heard during this Parliament? What has happened to the Secretary of State's press statement on 5 December in which he promised that appeals would be heard by this spring? Will the Minister at least assure us that they will be heard by next spring?

Mr. Freeman: The smooth running of the appeals machinery to which the hon. Gentleman refers has been clogged up by the unhelpful and unco-operative attitude of COHSE and the National Union of Public Employees.

Operations

Mr. Gill: To ask the Secretary of State for Health what action is being taken by individual health authorities to increase the number of operations where their current performance rate falls substantially below the national average.

The Minister of State, Department of Health (Mr. David Mellor): We expect health authority managers, who now have available to them information on their performance relative to others, to use this to monitor their own performance and then to make any necessary improvements. We have a range of initiatives to help support and sustain such efforts.

Mr. Gill: Does my hon. and learned Friend agree that after the massive increase in spending during the past 10 years on additional staff, new hospitals. other new buildings and modern equipment, the British taxpayer is


entitled to ask why we still have a waiting list? Is that not of itself sufficient justification for the Government's reforms of the National Health Service?

Mr. Mellor: Yes, particularly when some recent research showed that if every district health authority was capable of using its operating theatres as efficiently as the average—not even as the best—that would create enough vacant beds to allow everyone on the waiting list to be operated on immediately. That is the precise scope, and there are many other examples of what the added efficiency that we propose in the review will do for the National Health Service.

Mr. Nellist: What does the Minister say to a health authority such as Central Birmingham, which is responsible for the Birmingham children's hospital and which has limited the number of open-heart operations to 320, when the surgeons are capable of carrying out 380, and where the waiting list for children now stands at 140, when a year ago it stood at 110? That was at the time of the tragic deaths of David Barber and Matthew Collier, which my hon. Friend the Member for Coventry, North-East (Mr. Hughes) has raised repeatedly in the Chamber. What does the Minister say to those area health authorities that are putting the lives of bairns at risk? When will they get enough money so that surgeons can carry out the operations?

Mr. Mellor: I have every sympathy with the parents of youngsters awaiting such operations. A great deal of attention has been given to improving the position at Birmingham children's hospital. I am advised that double the number of heart operations on youngsters will be carried out at that hospital this year compared with last year. That marks real progress and I hope that we shall be able to do even more in the months ahead.

Mr. Burt: Will my hon. and learned Friend congratulate my health authority, Bury, on the way in which it has dealt with the issue and is able to treat more patients by increasing the number of consultants by 35 per cent. over the past five years? Will he note that it has achieved that by saving on administration and by putting more services out to tender? Is not that the way that health authorities should go?

Mr. Mellor: What is encouraging is the range of initiatives taken by different health authorities. I applaud what Bury has done and, equally, I applaud other health authorities which, by having a higher proportion of operating cases treated as day cases, have managed to transform their waiting lists. The Coventry and Warwickshire hospital, which I visited last month, has transformed a waiting list of 1,400 to a list of 300 simply by increasing the proportion of day surgery cases from 7 per cent. of the total work load to 43 per cent. We look to such initiatives, and that is the scale of improvement that is possible when people use their ingenuity.

Ms. Harman: Is it not the case that to stay within inadequate budgets, hospital managers are telling doctors to do fewer operations, rather than more? How does the Minister's earlier answer square with a report in yesterday's Daily Mirror that two heart surgeons at Birmingham children's hospital were threatened with disciplinary action because they exceeded by one the ration

of heart operations that they were allowed to carry out in May? Does that not show that the Government's real interest lies in saving money, not lives?

Mr. Mellor: This year, over 20 per cent. more in-patient cases will be dealt with in the National Health Service than were dealt with 10 years ago and there will be many more operations than there were last year. It is interesting that although the hon. Member for Livingston (Mr. Cook) made his usual call about underfunding, that was specifically not endorsed at the meeting between regional health authority chairmen and my right hon. and learned Friend the Secretary of State last week. The problems of the National Health Service cannot be explained away by a shortage of resources, but have much to do with improved performance. It is about time that the Opposition played some part in making that clear.

Bristol Channel (Pollution)

Mr. Speller: To ask the Secretary of State for Health what representations he has received about sickness, including ear, nose, throat or body sores, in bathers, fisherman or other users of the Bristol channel attributable to the poor water quality and high sewage or industrial pollution of this marine cul de sac.

Mr. Freeman: None. My right hon. and learned Friend is aware of recent concern expressed by the National Federation of Fishermen's Organisation to the Ministry of Agriculture, Fisheries and Food about the possible health risks to fishermen from sewage disposal to sea. The public have also expressed concern to my Department and to the Department of the Environment about the state of our bathing waters.

Mr. Speller: I thank my hon. Friend for his clear awareness of some of the problems. Is he aware that not only fishing clubs but swimmers, school parties, parents and all who use the Bristol channel complain bitterly of sore throats, sore eyes, stomach upsets and other unpleasantness, all of which they attribute to polluted water? Is he further aware that the waters of the Bristol channel were last tested in 1987 and that the results of that survey have yet to be analysed or published? Will he request all medical authorities and GPs near the Bristol channel to give him information on the problem, which I suspect is small individually but major nationally?

Mr. Freeman: I give my hon. Friend that assurance. We appreciate and welcome comments from not only district health authorities but general practitioners on reports from their patients about any ill effects from sea bathing. A contract has been placed with the independent water research centre to carry out a study to assess the risk of contracting illness from sea bathing. That study commences this summer, and we shall place the results in the Library.

General Practitioners (Contract)

Sir Bernard Braine: To ask the Secretary of State for Health how the new general practitioners' contract will affect the chances of night visits being made by a patient's own doctor.

Mr. Bellingham: To ask the Secretary of State for Health how the new general practitioners' contract will affect immunisation and screening policies.

Mr. David Nicholson: To ask the Secretary of State for Health how the new general practitioners' contract will affect the assessment of the development of young children.

The Secretary of State for Health (Mr. Kenneth Clarke): The new contract will introduce a higher visit fee for those doctors who visit patients themselves, or who arrange night cover in small rotas of no more than 10 doctors. I believe that this will encourage general practitioners to carry out more home visits themselves or ensure that their patients see a doctor whom they know.
The new payments for the achievement of specified levels of childhood immunisation and cervical cytology will offer GPs a powerful incentive to raise protection against diseases for their patients.
The new contract will introduce for the first time a fee for GPs who provide services to monitor the development and well-being of their child patients.

Sir Bernard Braine: Although a deputising service clearly has its uses, does it not make sense for general practitioners to have an incentive to visit their patients rather than to encourage the attendance of deputies, who may have had absolutely no contact with the patients, particularly elderly patients? If anyone had any doubts before, does this not clearly show that the function of the new contract is to improve the quality of service to the patient?

Mr. Clarke: I am grateful to my right hon. Friend. His point will be endorsed by his constituents who much prefer, wherever possible, a visit by a doctor from their own practice or one in close contact with it. I am glad to say that the majority of GPs do not use commercial deputising services. It is fair that they should be paid a higher reward for that. I regret to say that, at the moment, the general medical services committee is seeking to reopen discussions with me on the higher fee. I see no basis for that. We must remember the patients' interests and the public interest in settling the contract.

Mr. Bellingham: I am grateful to my right hon. and learned Friend for that reply. Does he agree that good doctors have nothing to fear from the new contract? Will he confirm that, in future, in places such as west Norfolk, where there is a large retired population, people will get even better service from their GPs and will not mind them receiving extra rewards?

Mr. Clarke: We are very conscious of the increasing number of elderly patients and the increasing needs of elderly patients, particularly those beyond the age of 75. That is a growing feature of the population of Norfolk. Patients would welcome the introduction of a new higher fee for GPs in return for keeping at least in annual touch with all their patients over the age of 75.

Mr. Nicholson: My right hon. and learned Friend will be aware of my concern that the National Health Service should cope with the needs of patients of all ages, particularly young children. Does he agree that his earlier replies give the lie to claims that the new contract would

work against patient care? What can he do to bring home to GPs the considerable benefits to patients from the new contract?

Mr. Clarke: I am glad to say that the new payment for child surveillance, which is monitoring the development and health of children under the age of five, was put into the contract at the request of the medical profession and the GMSC. It is one of many features of the contract that should encourage much better service to patients. Many GPs have still not altogether understood all the details of the contract on offer. They should realise that the resulting contract must be on a balance between the legitimate interests of the profession and the legitimate needs of patients to ensure that general practice maintains the highest international standards.

Mr. Foot: As the right hon. and learned Gentleman was originally appointed to his post because of his great powers of communication—we might call him the "Kenneth Baker of yesterday"—can he give the House an estimate of what would have been the response from doctors to the new contract without his great clarity and vision?

Mr. Clarke: I remain a colleague of Kenneth Baker today. I have certainly communicated with doctors. I and my negotiating team have had 19 meetings with the GMSC negotiators, spent 110 hours in negotiation and produced 38 papers as bases for discussion. We eventually reached an agreement that the GMSC recommended to the profession.
Obviously, I regret the fact that GPs have decided to reject the recommendations of their own negotiators, but at least it was not by the nine to one vote that greeted Aneurin Bevan when he tried to persuade the British Medical Association to accept his terms of service when the NHS was founded.

Mr. Duffy: The hon. Member for Norfolk, North-West (Mr. Bellingham) referred to the elderly. Is the Secretary of State aware that in Sheffield the most freely expressed fear about the new contract is that it will prejudice the dedication of services and resources to the elderly, especially in respect of night visits? Will he comment on the effect of the new contract on Sheffield's elderly population, especially as it is expected that the number of those over the age of 85 will increase by 82 per cent. during the next decade?

Mr. Clarke: I do not accept the interpretation that the hon. Gentleman claims has been put upon the contract by some doctors in Sheffield. As I have already said, we are introducing a new, higher payment in exchange for regular contact with patients over the age of 75. The new contract will benefit the elderly, who would much prefer that, whenever possible, night visits are made by someone from their own practice whom they are likely to know.

Ms. Mowlam: Will the right hon. and learned Gentleman make it clear that doctors will not be paid for immunisations and screenings if they do not achieve a minimum target of 70 per cent. of their patients? In an area such as Teesside, doctors, however hard they try, will have great difficulty in reaching that high target. It is a question not of good or bad doctors but of a target that is unattainable.

Mr. Clarke: Vaccination is part of the ordinary duties of every GP. I am sure that they all accept that they must strive to raise the level of immunisations. The 70 per cent. target is already being met by the majority of practices, certainly in England, and it can be achieved regardless of the social status of an area. It is important to try to secure a National Health Service that meets the highest international standards of patient care. The target that we have set is that recommended by the World Health Organisation, and none of us should recommend second-rate or lower standards for the NHS than those regarded as reasonably attainable in developed countries.

Mr. Cormack: Although it may be true that, as my hon. Friend the Member for Norfolk, North-West (Mr. Bellingham) said, the majority of doctors have nothing to fear from the new contract, does my right hon. and learned Friend accept that some excellent doctors are apprehensive? Despite his efforts through meetings, papers and discussions, does he agree that there is a need for a concerted effort during the next three months, when Parliament is not sitting, to talk to doctors throughout the country in as conciliatory and constructive a manner as possible, in the hope of persuading them that they have nothing to fear?

Mr. Clarke: My two ministerial colleagues and I hold meetings with hundreds of doctors each week, and they have been successful and productive. One of the main actions that we can take is to explain the impact of the contract to individual GPs, many of whom are labouring under unreasonable and unnecessary fears about a possible loss of income in their practices. In fact, the best doctors will gain under the proposals, but some will have to improve their performance. Many doctors are labouring under a misunderstanding because they have not absorbed the detail of the new contract. I shall take my hon. Friend's advice and I shall almost certainly communicate in writing with all GPs, setting out the terms on offer.

Community Care

Mr. Simon Hughes: To ask the Secretary of State for Health if he will make a further statement on his plans for community care.

Mr. Kenneth Clarke: As I said in my statement on 12 July, we will publish a White Paper on community care in the autumn.

Mr. Hughes: Will the Secretary of State elaborate on the arrangements for community care between now and 1991? He will be aware that many elderly and mentally ill people are already being discharged into the community, particularly in inner-city areas such as mine, and that facilities are already insufficient. Will he examine projects such as that proposed for St. Olave's hospital in my constituency where there is a danger that half the land will be sold for housing at market value rather than for the community care provision that would allow his plans to be implemented in the near future rather than having to wait until 1991 or thereafter?

Mr. Clarke: Our response to the Griffiths report aroused great enthusiasm among local authorities for the opportunity that it offers to improve the level of community care that we provide. I am sure that local

authorities and health authorities are beginning to draw up their community care plans and to plan for new developments. Therefore, as a result of the announcement, increased priority will be given to community care immediately. I trust that that means a steady development before we reach 1991. I shall look at the constituency case to which the hon. Gentleman referred when he sends details to me and if there is ministerial responsibility, the Minister responsible will respond to him.

Mr. Butler: Do the community care proposals involve a review of attendance allowances with a view to making them more prompt, efficient, generous and sensitive?

Mr. Clarke: All of us become involved in appeals against refusal of attendance allowance, and I know how difficult many of those cases are. The Griffiths report did not specifically address the important matter of the benefits and financial assistance given to disabled people and those who care for them. I shall draw my hon. Friend's remarks to the attention of my right hon. Friend the Secretary of State for Social Security and I have no doubt that he will bear his point in mind.

Mr. Tom Clarke: Will the Secretary of State explain why, in his recent statement on community care, he made only a passing reference to Lady Wagner's report? Does he accept that, in view of the huge explosion in residential care, especially in the private sector, there is a need for minimum standards in the private and the public sectors and for proper inspections, too?

Mr. Clarke: Lady Wagner's report was excellent and the Government are grateful to her. Many of its recommendations have already been implemented. We endorsed it yet again in my statement, and we touched on her suggestions for the inspection of nursing and residential homes where we did not see any need for change in the statutory position at the moment. We introduced the legislation that brought in the system of supervising standards and we have made important recommendations which will help local authorities so to organise matters that the same attention is paid to the standard of care in public sector homes as should be paid in private sector homes.

Limited List

Mrs. Maureen Hicks: To ask the Secretary of State for Health how many complaints he has received from patients and general practitioners in the last four years as a result of the introduction of the limited drugs list.

Mr. Mellor: Since the selected list scheme was introduced in April 1985 the Department has received some 6,000 letters about the scheme, but not many recently. Recent correspondence has tended to recognise that the selected list scheme has produced worthwhile financial savings while fully protecting the interests of patients. None of the dire predictions made at the time of the introduction of the scheme by the British Medical Association and others has proved to be true.

Mrs. Hicks: My hon. Friend will recall only too clearly that the outcry and fears expressed by general practitioners four years ago before the introduction of the selected list was not dissimilar to the present outcry from general practitioners about prescribing costs. For the sake of those


vulnerable patients who are completely confused, will my hon. and learned Friend take the opportunity to bang on the head once and for all the untruth going about that any patient might be denied medicine? Will he reassure the elderly and those on long-term medication that they have nothing to fear under the Government?

Mr. Mellor: I am very happy to give my hon. Friend the reassurance that she seeks. Every patient will receive the medication that they require—that is a categorical promise. Despite the controversy over the limited list, it establishes that worthwhile savings of about £75 million per year can be made, which can be deployed elsewhere in the Health Service to the greater benefit of patients. The controversy shows also that, unfortunately, some groups within the Health Service are so resistant to changes that they will seek to blackguard them with the most wild charges—none of which, in respect either of the selected list or of other reforms, has proved to be true. The same will doubtless be true of the dire predictions made about the White Paper.

Mr. Rooker: One of the drugs that is the subject of most concern and, I suspect, of most representations, is Mucodyne—which was restored to the list, but only in the children's version. Many elderly people suffering from bronchial complaints, including a number of my constituents, have found no substitute for Mucodyne that meets their needs, and must fork out about £13 or £14 every time that they purchase a bottle. They have no choice because there is no proven, practical alternative. Mucodyne has also been the subject of many parliamentary questions, and I ask the Minister to bear my comments in mind if the list is ever reviewed.

Mr. Mellor: The hon. Gentleman knows that the drugs included on or omitted from the selected list were the subject of professional evaluation by an advisory committee, so those decisions were taken not by the Government but on specialist advice. The hon. Gentleman will know also that we offered the British Medical Association an appeal mechanism but it did not take us up on it. That would have been a way of dealing with any residual points.

Dame Jill Knight: Is not the simple truth that if my right hon. and learned Friend and his colleagues had listened to the BMA's campaign against the limited list, £75 million per year less would have been available to spend on patients?

Mr. Mellor: Yes, and that £75 million equals the cost of building a new Great Ormond street hospital every year for the past four years. That is what the debate is all about. Of the £2 billion currently spent in the NHS on prescribed drugs, tens of millions of pounds is misspent because of the refusal by some general practitioners to prescribe generic alternatives, slack repeat prescribing, and other reasons. Just as it is necessary for patients to have the drugs that they need, it is important that patients are not prescribed drugs that they do not need.

Hospitals (Self-governing Status)

Mrs. Mahon: To ask the Secretary of State for Health if he has issued any guidance to health authorities on balloting National Health Service staff or members of the public on whether they agree with proposals to allow National Health Service hospitals to opt out.

Mr. Kenneth Clarke: No National Health Service hospitals are going to opt out of the National Health Service.

Mrs. Mahon: Is the Secretary of State aware of the overwhelming wall of hostility against his proposals for futuristic private hospitals? If the right hon. and learned Gentleman believes that his proposals have the support of doctors, nurses, patients and the public, why does he not put them to the test by balloting Health Service workers and the public? He has spent enough taxpayers' money trying to sell that rotten idea.

Mr. Clarke: Recently, the hon. Lady, together with some of her colleagues, gatecrashed a meeting that I was holding with the staff of various hospitals in Leeds. The hon. Lady and her friends found themselves listening to a very serious discussion about the potential benefits of self-government for hospitals and units in the Leeds area, and found it so daunting that they left after a little while. If the hon. Lady and her friends had stayed, they would have understood my proposals more clearly. Clearly, the hon. Lady still does not understand them—and obviously she is not ready herself, let alone her constituents, to cast a vote on the matter. If we receive any applications for self-governing status from NHS hospitals, as I am sure that we shall in due course, we will consult most thoroughly—as we always do on any serious proposal.

Mr. Hayes: Does my hon. and learned Friend agree that balloting hospitals and the community would be as ludicrous as it would be unworkable? Does he agree that it would divide communities and hospitals, and divert valuable time and resources away from the Health Service?

Mr. Clarke: I am accused of challenging one or two of the Health Service's traditions, but I am not very much in favour of traditions that lead to inefficiency. However, I cannot recall a single occasion in the past 40 years when anyone has suggested that managerial changes should be the subject of a local ballot. At this stage, people should concentrate on seriously studying the Government's proposals, and wait to see what applications are made and what would be the benefits to the patients concerned.

Mr. Galbraith: I presume that when the Government presented their proposals they discussed the decision that the managers and consultants involved would determine whether hospitals should opt out of local health authorities, and that the local community would be considered. If the majority of consultants in a hospital were opposed to that hospital's opting out, would it still be able to do so?

Mr. Clarke: I have never used the phrase "opt out". It has not featured in any of my documents or speeches. The self-governing hospitals, like other hospitals, will look to the district health authorities for funds, as money comes with the patients referred by those authorities.
Let me suggest again that the description of the proposal that we have heard is based on misunderstanding, or is misleading. We shall consult in the ordinary way when applications are made, but I do not believe that such matters can be decided sensibly by means of a yes or no vote among any particular section of staff, or in any other part of the community. Those responsible will put forward considered applications that will be examined in the same way as any other important changes in the service.

NHS Reform

Mr. Norris: To ask the Secretary of State for Health if he will make a statement on the allocation of the extra £40 million to help with the implementation of the White Paper "Working for Patients".

Mr. Kenneth Clarke: I have undertaken to ensure that the costs of implementing the NHS review will be met by the taxpayer over and above the resources provided to maintain the growth of services to patients. The provision of the additional £40 million brings the total available this year for the implementation of the review to £82 million, of which £70 million is for the hospital and community health services, £5 million for the family practitioner services and the remainder to meet administrative costs in my Department.

Mr. Norris: Does my right hon. and learned Friend agree that hard-pressed managers in the NHS deserve our full support, and that those additional resources are a welcome and constructive step towards implementation of the White Paper proposals? Does he agree that they are especially to be welcomed as new money that will leave untouched the existing record level of resources for patient care?

Mr. Clarke: I am grateful to my hon. Friend. As he knows, the great majority of managers in the service are very enthusiastic about the reforms proposed in the White Paper, and are working extremely hard to ensure their implementation. Some investment up front will, as I have said, be required, and we shall continue to provide it over and above the necessary increase in resources required to maintain the growth in patient care.

Mrs. Dunwoody: How much of that new money will be allocated to patient care, and how much to the provision of hardware, accountants and software to be employed in billing procedures? It is rather important for the patient to know what he is spending the money on.

Mr. Clarke: As the hon. Lady knows, in last year's public spending round we increased total spending on the National Health Service by £2 million. With additions during the year, we have brought the amount to be spent on the implementation of the review to £82 million. That covers a wide range of services, including grants for the training of more people with public health expertise who will be able to identify patient needs. Those needs will be resourced much better once the new system is in place.

Mr. Favell: Has my right hon. and learned Friend made any assessment of the savings that will be made by the streamlining of the decision-making process in self-governing hospitals? At present, as he well knows, major decisions must go first to the district health authority, then to the regional health authority, then to the Elephant and

Castle and then all the way back down the line. Is it not true that savings will be made and that for all but the third rate, this will be a far better process?

Mr. Clarke: Over the years we have moved steadily towards replacing the second-guessing of decisions that has been traditional in the Health Service, when Ministers and their civil servants supervised the regions, which supervised the districts, which supervised hospital management. With self-governing hospitals, we shall put real responsibility into the hands of local people.
I agree with my hon. Friend that great improvements will be made in efficiency, and that at the same time the hospitals will be made even more responsive to local opinion, local patients' needs and perceived gaps in the present health care provision.

Mr. Robin Cook: Will the Secretary of State accept that we agree that this latest share-out shows the Government's priorities? Is he aware that three quarters of the new money has been spent on more finance staff and more computers for them, but only a couple of million pounds on the medical audit? Does it not speak volumes for the priorities of his White Paper that the accountants who treat no patients need 12 times the new resources that are given to doctors? Is not the truth that his priority is cost control, not patient care?

Mr. Clarke: The hon. Gentleman makes a specialty of picking out details of the White Paper that he blows up into misrepresentations. He knows perfectly well—[Interruption.]

Mr. Speaker: Order.

Mr. Clarke: This will be planned and brought in by the profession. The additional £2 million is extremely welcome to the profession and shows our good will to that development. We accept that more money will be required to finance medical audit when the profession has in place the mechanisms required to carry it out. We are talking about £2 million being spent on pump priming for that purpose this year.

Mr. Squire: Will my right hon. and learned Friend take all possible steps to implement the White Paper at the earliest opportunity so that my constituents, who are suffering excessive waiting lists in Barking, Havering and Brentwood, have the advantage of one of the White Paper's many proposals—that money should follow patients rather than some abstruse formula?

Mr. Clarke: I am grateful to my hon. Friend, and I reassure him that progress on preparation to implement the review is going steadily and very well at present. We seem well on target to deliver not only the review but, most important, its benefits to patients such as his constituents, who will experience a big improvement in how the service is delivered once the changes are in place.

Mr. Speaker: Order. It is difficult to hear questions against a background of discussion.

Artificial Limbs

Mr. Morgan: To ask the Secretary of State for Health what consultations he has recently undertaken regarding the supply, and fitting and repair of artificial limbs.

Mr. Mellor: These matters are dealt with in England by the Disablement Services Authority. We are regularly in touch with the authority's chairman.

Mr. Morgan: What on earth possessed the right hon. Gentleman's Department to bring wholly improper pressure on the Welsh health common services authority to award its three-year contract for the supply of artificial limbs in Wales to Intermed? Its artificial limbs may be straight, but its behaviour is so bent that two days after it was awarded the contract, which specified local manufacture at Rookwood hospital in my constituency, it said that it would move the manufacture and major repair of all artificial limbs for Wales to its central factory in Alton, Hampshire, contrary to the recommendations of the McColl committee on the supply of artificial limbs that manufacture and major repairs must always be done in the locality.

Mr. Mellor: Arrangements in Wales are a matter for the Welsh Office, not the Department of Health. Prior to our beginning this exercise, Intermed's share of the lower limb market was 75 per cent. in England, but it is now 16 per cent. I should have thought that that was a move in the direction that the hon. Gentleman wants.

Miss Sharon Campbell

Mr. Atkinson: To ask the Secretary of State for Health, pursuant to his answer to the hon. Member for Oxford East (Mr. Smith) of 6 June, Official Report, columns 97–99, what other action has been taken in response to the report of the committee of inquiry into the care and after-care of Miss Sharon Campbell, Cm 44; and if he will make a statement.

Mr. Freeman: We continue to carry forward work which calls for Government action, particularly that concerned with the continuing care of patients discharged from mental illness hospitals. We will begin formal consultation on guidance on continuing care this Friday.

Mr. Atkinson: Will my hon. Friend confirm that his plans to improve health services for the mentally ill, which he announced in a detailed response to a question asked by my hon. Friend the Member for Eddisbury (Mr. Goodlad) on 13 July, take account of the findings of the Sharon Campbell inquiry and go a long way to ensuring that such a tragedy never happens again?

Mr. Freeman: The statement of the Government policy on care of the mentally ill in the community made on 13 July was widely welcomed by hon. Members and the voluntary organisations involved. The announcement by my right hon. and learned Friend the Secretary of State of additional money in 1991–92 through the Health Service to help local authorities improve the quality of social care will go a long way to addressing some of the concerns that he and the Spokes report on the care and aftercare of Miss Sharon Campbell raised.

General Practitioners (Contract)

Mr. Baldry: To ask the Secretary of State for Health if he will make a statement on the effects of the new general practitioners' contract on health promotion clinics.

Mr. Harry Greenway: To ask the Secretary of State for Health what are the implications of the new general practitioners' contract for preventive health care.

Mr. Mellor: The new contract forms an important part of our policy of encouraging health promotion and the prevention of ill health. GPs' terms of service will make clear their role in these areas, and there will be new payments encouraging the provision of health promotion clinics, check-ups for newly registered patients and help to achieve high levels of coverage for cervical cancer screening and childhood immunisations.

Mr. Baldry: I thank my hon. and learned Friend for that reply. Does he agree that the provision for the first time of an incentive to general practitioners to run health promotion clinics will greatly improve the quality of patient care and provide GPs with the opportunity not just to react to problems as they come through their doors but to raise the quality of health of the patients on their lists?

Mr. Mellor: Yes, it is absolutely vital that the NHS becomes a service for health and not just a service for sickness. The way in which we have chosen to have a contract that is performance related will, for the first time, properly reward those who take the initiative in preventive medicine, rather than merely reward those who have been in practice for a long time, unrelated to performance.

Mr. Greenway: Can my hon. and learned Friend confirm that in terms of preventive medicine, the new contract for GPs will, for the first time, require them to visit elderly patients, that they will be paid to make those visits and that the visits will have to take place at least once a year? Will he confirm that they will be thorough visits and that the elderly people being visited will be properly looked after?

Mr. Mellor: For the first time, GPs will be paid more for having elderly patients on their lists. I find it astonishing, therefore, that the charge should be levelled at the contract that somehow it will make it more difficult for elderly patients to get treatment, when for the first time they are singled out as being patients whose care requires extra payment from the state.

Oral Answers to Questions — PRIME MINISTER

Engagements

Mr. Flannery: To ask the Prime Minister if she will list her official engagements for Tuesday 25 July.

The Prime Minister (Mrs. Margaret Thatcher): This morning I had a number of meetings. I then received General Yazov, the Soviet Defence Minister, on his first visit to the United Kingdom. In addition to my duties in the House, I shall be having further meetings later today and will be attending a special garden party to celebrate 150 years of public education. This evening I hope to have an audience of Her Majesty the Queen.

Mr. Tony Banks: Is the right hon. Lady intending to reshuffle her as well?[Interruption.]

Mr. Speaker: Order. It is a good thing that I cannot hear many of the sedentary remarks that are made.

Mr. Flannery: Now that the Prime Minister has guillotined half the Cabinet and frightened the other half


to death, can I assume that that is an admission that all the fundamental policies of the Conservatives have been wrong? [HON. MEMBERS: "Yes."] Is it not a fact that they have been wrong in, for instance, education, the economy, the poll tax, water and pollution? [Interruption.] It is clear that hon. Members in all parts of the House agree with me. Is the right hon. Lady now for turning, or will the developing chaos of wrong policies continue, to the detriment of the British people?

The Prime Minister: I do not think that the hon. Member can count. His side, the Labour Opposition, is constantly changing its policies, which is not surprising considering that they have had, and still have, such a rotten set. We sometimes change members of our Cabinet and Administration in order to pursue the same policies which have brought success to the British people for so long.

Mr. Michael Morris: While my right hon. Friend the new Foreign Secretary is getting his feet under the table, will my right hon. Friend contact the Indian Prime Minister and express to him the disquiet of many in the House about what is happening in India's relations with Nepal and Sri Lanka?

The Prime Minister: My right hon. Friend the Foreign Secretary has of course had his feet under the same table, as a very effective Chief Secretary, for a long time.
I saw the Prime Minister of India recently in Paris and had long talks with him. Obviously, he is taking an active part in the difficult questions that face Sri Lanka. I am sure that he will consider everything carefully in the interests of the people there, of the people of India and of his own army. I also know of the difficulty that is being encountered over Nepal and of the disquiet that it is causing in some parts of this House.

Mr. Kinnock: Will the Prime Minister be good enough to convey my congratulations to the former Foreign Secretary on his promotion? Can the Prime Minister tell us whether the appointment of the right hon. and learned Gentleman is intended to result in any changes in policy?

The Prime Minister: As usual, the right hon. Gentleman cannot have listened to previous answers before he came up with his prepared question. I made it quite clear in my previous reply that changes in the Cabinet will mean that the policies that have been so successful in Britain, and so successful in the House, will continue, because we have the right policies and they have transformed our country.

Mr. Kinnock: If the Prime Minister is saying that no changes are needed, is she disagreeing, at this early juncture, with her new deputy, who said this morning that he was needed
particularly when the Government as a whole are facing a new round of problems on the home front"?

The Prime Minister: We shall deal with those problems in this Cabinet as effectively as we dealt with previous problems. I quite understand that the right hon. Gentleman is once again going on about personalities because he is not capable of asking a question on policy.

Mr. Robert G. Hughes: Will my right hon. Friend join me in welcoming the Government's decision that Sikh workers on building sites no longer have to wear hard hats? Does she agree that this will be welcomed by many ordinary Sikh people, who will be able to go about their

business and do their jobs, and that this demonstrates the Government's understanding attitude to towards ethnic minority British people?

The Prime Minister: I know that this decision will be welcome to the Sikh community. My hon. Friend will also be aware that employers will be relieved of any compensation that might come about because Sikhs are not wearing hats but, in general, I believe this will be welcome to the Sikh community.

Dr. Owen: While we welcome the new Foreign Secretary, may we have a pledge from the Prime Minister that she does not intend to interfere incessantly, and that, if he wishes to make a statement to the House on society, whether British or foreign, she will not cross it out?

The Prime Minister: I have great confidence in the present Foreign Secretary, as I had in the previous one. I notice that the present Foreign Secretary has taken over after quite a prolonged period of office in Cabinet, unlike the right hon. Gentleman before he was made Foreign Secretary.

Mr. Cormack: Will my right hon. Friend turn her attention later today to the problem of London's traffic? Does she agree that, whether there is a strike or not, London is grinding to a halt, and that we need to consider such solutions as banning deliveries during certain hours and banning cars that contain fewer than a certain number of passengers? Does she agree that unless drastic solutions are found London will grind to a halt?

The Prime Minister: I am aware that my hon. Friend is concerned, and that he will be more concerned at another totally unnecessary strike tomorrow because the National Union of Railwaymen did not accept the result of an independent arbitration. I know that increased prosperity, and the increased number of cars, brings increased traffic problems. This is a traffic problem and my right hon. Friend the new Transport Secretary will be looking at that, among other things.

Mr. Wareing: To ask the Prime Minister if she will list her official engagements for Tuesday 25 July.

The Prime Minister: I refer the hon. Gentleman to the reply that I gave some moments ago.

Mr. Wareing: Having carried out a reshuffle of her Cabinet of doormats, is the Prime Minister aware that the British people do not appreciate the Right-wing extremism of the Government's policies, nor do they trust her to handle the National Health Service now that it has been revealed that so many local health authorities are having their budgets cut? Does the Prime Minister realise that the day that millions of people in this country yearn for is the day when they see the back of her?

The Prime Minister: No. As the hon. Gentleman knows, the policies followed by the Government have brought a higher standard of living to this country than has ever been known and a higher standard of social services than could ever have been provided by previous Governments. I do not think that the people wish to return to the awful standard of living, awful health services and the terrible domination by the trade unions that were the characteristics of previous Labour Governments. Cheer


up—I notice that even the Labour party is trying to move Right because it thinks that those policies are more popular.

Mr. Greg Knight: Can my right hon. Friend confirm that the average law-abiding football fan has nothing to fear from the passage into law of the Government's Football Spectators Bill? Will not the only type of person placed in difficulty be the hooligan, the person who regularly exhibits bouts of threatening behaviour such as swearing in public, perhaps to a radio interviewer, or causing fights in the streets, say, outside an Indian restaurant?

The Prime Minister: I agree with my hon. Friend. The Football Spectators Bill will give us extra defences against hooligans and extra powers to get better grounds. I agree that the law-abiding spectator will welcome it. The legislation also gives us a basis on which to bring into law any proposals resulting from the Hillsborough report without having to wait a further year.

Mr. Campbell-Savours: To ask the Prime Minister if she will list her official engagements for Tuesday 25 July.

The Prime Minister: I refer the hon. Gentleman to the reply that I gave some moments ago.

Mr. Campbell-Savours: On Mr. Tiny Rowland's campaign in The Observer on Tornado, the House of Fraser and other matters, did the Prime Minister ever meet the Sultan of Brunei and discuss the takeover of the House of Fraser? Is it true that the report by the independent directors of The Observer into that newspaper was a whitewash in so far as it believed Mr. Rowland when he said that he did not have links with Dassault, while at the same time Lonrho employees were busily briefing Fleet street, especially Jon Craig of the Sunday Times, saying that there were commercial links between Lonrho and Dassault? Is it not about time that Mr. Rowland divested himself of control of The Observer?

The Prime Minister: I have no information on the hon. Gentleman's last point, but I am aware that the hon. Gentleman has tabled a number of early-day motions on this point. It would not be right for the Government to make any comment while the investigations concerning the House of Fraser continue. I meet the Sultan of Brunei from time to time to discuss matters of state. He is a very good friend of Britain.

Mr. Bellingham: Is my right hon. Friend aware that the majority of east coast ports are now working normally? Is she aware also that unemployment in King's Lynn has come down from a high of more than 15 per cent. to under 5 per cent. and that with a new, reinvigorated port unemployment should disappear altogether?

The Prime Minister: Dock workers are steadily returning to the ports. I think that they realise that there is no point in a strike. They are more keen to build a future for the ports in which they work and for the industries in the hinterland of those ports. The passing of the Dock Work Act was a good decision for the future prosperity of my hon. Friend's area and for all those in the hinterland of those ports.

Mr. Skinner: To ask the Prime Minister if she will list her official engagements for Tuesday 25 July.

The Prime Minister: I refer the hon. Gentleman to the reply that I gave some moments ago.

Mr. Skinner: Does the Prime Minister agree that as she has not sacked or moved the Chancellor of the Exchequer, the Home Secretary or the Secretary of State for Wales, they must have been the most successful members of the Cabinet? Will she confirm that she has moved the Secretary of State for the Environment, who did not have the presentational skills to sell the poll tax? That being so, against the background of a massive trade deficit, how will he sell our goods abroad?

The Prime Minister: I think that the hon. Gentleman must be very satisfied with the overwhelming majority of policies that are being pursued by this Government and bringing such prosperity to this country. With regard to the community charge, I understand that many Opposition Members wish to have high expenditure but do not wish to contribute to it. That is totally and utterly wrong. As the hon. Gentleman knows, the community charge will contribute to only 25 per cent. of local authority expenditure in England, only 18 per cent. of local authority expenditure in Wales and only 14 per cent. of local authority expenditure in Scotland. It will be a much, much fairer charge than any previous charge, and I note that the Labour party has abandoned its latest policy because it is absolutely rotten.

BILLS PRESENTED

MOTOR VEHICLES (MILEAGE READINGS)

Mr. Nigel Griffiths, supported by Mr. Gareth Wardell, Mr. Tony Lloyd, Mr. Michael Latham, Sir Hal Miller, Mr. Tom Cox and Mr. Roy Hughes, presented a Bill to require the Department of Transport to establish a register of the mileage of each motor vehicle whenever ownership is recorded or transferred, and on every occasion that the vehicle is licensed; and to require the owner of the vehicle to supply this information: And the same was read the First time; and ordered to be read a Second time on Friday 20 October and to be printed. [Bill 195.]

MOTOR TRADE (CONSUMER PROTECTION)

Mr. Nigel Griffiths, supported by Mr. Roger King, Mr. Tom Cox, Mr. Gareth Wardell, Mr. Tony Lloyd and Mr. Roy Hughes, presented a Bill to seek to control the activities of motor dealers and in particular to ensure the protection of consumers in respect of roadworthiness and a description of motor vehicles: And the same was read the First time; and ordered to be read a Second time on Friday 20 October and to be printed. [Bill 196.]

PREVENTION OF ACCIDENTS (RANDOM BREATH TESTING)

Mr. Nigel Griffiths, supported by Sir Philip Goodhart, Mrs. Rosie Barnes, Mr. John Home Robertson, Mr. Roland Boyes and Mr. Tony Lloyd, presented a Bill to make provision for police officers to conduct random breath tests on drivers to deter drinking and driving: And the same was read the First time; and ordered to be read a Second time on Friday 20 October. [Bill 197.]

Ban on Imports (Child Labour)

Mr. Jimmy Dunnachie: I beg to move,
That leave be given to bring in a Bill to prohibit the sale of imported goods, the manufacture of which has involved child labour.
I place before the House a Bill that seeks to ban the import of goods that have been produced using child labour. I do so because to use children in this way is a crime. It denies their right to be treated as human beings while, at the same time, denying the right of adult workers to earn a wage worthy of their labour. As long as we buy the goods that child labour produces, we help to maintain a system that our own history has proved evil.
Today, I shall cite examples of child exploitation in India, Bangladesh, Thailand, Malaysia, South America, Turkey and Portugal. This is only scratching the surface, because child labour is so commonly used that it is impossible to detail the full extent of its misery in 10 minutes.
Children today work in conditions every bit as wretched as those that prevailed in the darkest days of our own industrial revolution—when little mites were forced to toil from dawn till dusk in unhealthy, poorly lit, badly ventilated and highly dangerous conditions because the pittance doled out to them by the profit-hungry capitalists was needed to eke out the miserable wages that were grudgingly given to their parents.
Such vile conditions epitomise the very worst of those Victorian values that are so highly revered in certain quarters—values that set the human soul at naught in the all-pervading pursuit of profit.
My interest in the evils of child labour was aroused by various media reports, and, while I am pleased at the number of hon. Members who have signed the early-day motion that I tabled at Easter, I am sorry that the Government would not name the high street stores that currently sell goods that have been made using child labour, because, every day, all over the world, children are abused as they produce many of the goods we buy. Often they work in conditions of slavery—always in conditions of misery and injustice.
This is clearly seen in the now infamous story of India's carpet boys. In the state of Uttar-Pradesh 100,000 children work their weary little fingers to the bone as they knot carpets, 90 per cent. of which are exported. Children as young as five and six work up to 15 hours a day, seven days a week, and a boy of seven is described as a "skilled craftsman". They get just enough food to keep them working, are frequently beaten, and often have to sleep beside their looms because they do not have homes to go to as they have either been kidnapped or sold into debt bondage.
One of the biggest British Firms using looms here is E. M. Hill and Co., which pays its loom owners £105 for a carpet. The loom owner, in turn, may pay his four children £4 each—that is, if he pays them at all. What price the status symbol of those handwoven Indian carpets that sell in some London stores for from £1,200 to £5,000?
Next to that cruelty are the flames reminiscent of Dante's "Inferno", whose deafening noise drowns out the piteous cries of those who toil amidst blazing furnace temperatures, designed to rent asunder body and soul.

Life's punishments are meted out by making the doomed slave in temperatures of 1,800 deg. as they are forced to stretch into the mouth of a furnace to draw out molten material. They then have to run, carrying it on a seven-foot ladle, trampling on broken glass on the way. In such a hell-hole, is it any wonder that tuberculosis is rife, and hideous accidents and burns commonplace?
Yet those are the conditions that little children of eight and nine have to work in as they toil in India's glass factories. Their labour is deemed to be so necessary that the owner of the C. A. glass works, where Nescafe jars are made, has been quoted as saying:
The glass industry cannot function without children. They can run much faster than adults and therefore production goes up.
Similar conditions apply in neighbouring Bangladesh. The Daily Record recently exposed the shame of the Scottish tea company, James Finlay, whose chairman, Sir Colin Moffat Campbell, was quoted as saying:
We are very proud of our achievements over there in Bangladesh.
Those achievements involve adults having to work for 60p a day and children having to work with them. Sir Colin's claim not to employ child labour is on a par with the description of his home at Kylbryde castle as "just a medium-sized house". Thank God I do not share his values.
In Thailand, poor people are often forced to sell their children into slavery and a quarter of the work force is aged between 10 and 14. As outlined recently in the magazine Marie-Claire, conditions in Thailand's sweat-shops make those described by Charles Dickens read like life in a holiday camp. Examples have been given of children working in a soya sauce factory from 5 am one morning until 2 am the next. Others in an electric light factory have to cut through bare wires with their teeth. In a factory that makes plastic straws, kids work from 5 am until 11 pm, after which they are locked up to stop them running away.
In Malaysia, many children are forced to work as part of the family unit because their parents are too under-nourished to have the strength they need to meet their daily rubber quotas. The quotas are becoming more and more difficult to meet as the demand for latex products grows with the AIDS epidemic.
The BBC programme, "Child Slaves", also showed recently that children have to work as part of the family unit in Mexico where, at the age of 12 or 13, they have to tend the crops to make sure that the man from Del Monte says yes, that everything is ship-shape in Captain Bird's Eye's garden and that life stays jolly in the valley of the Green Giant. Life is anything but a barrel of laughs for the kids whose youth is eaten away by the greed of the multinationals. The "real thing" for kids in Brazil means that they have to toil in the sugar plantations to make sure that "things go better with Coca Cola" for the millions who drink it.
Nor can Europe be complacent. Children as young as 10 have been found working in the sweatshops of Turkey, sewing garments for customers who often ask that the products reach them without labels so that they can then sew in their own, unblemished by the sweaty calluses on the tiny palms that made them.
Everyone knows that Portugal's shoe trade has been allowed to flourish at the expense of British jobs. Its cheap shoes are in most high street stores. Even though Portugal


has been a member of the EEC for three years, many of those shoes are still made using child labour. Firms such as Marks and Spencer say that they try to ensure that the shoes they sell have not been made by exploiting children, but why do they not guarantee it?
I fear that, all too often, reasonable prices hide the real cost of the products that we are asked to buy, in terms of the misery and suffering that have produced them. Opponents will argue that such is life, and that to ban the imports would make life even worse for the children. Balderdash! Two wrongs do not make a right in any language and so long as we stand back and do nothing, we condemn more children to endure hell in their short lives here on earth. The time for mere sympathy is over. We must act now to make sure that child exploitation is ended.
Britain can give a lead here, because we are one of the biggest importers of goods that have been produced by child labour. We must now become the voice of conscience, through which the silent pleas of the abused cry out for mercy.

Question put and agreed to.

Bill ordered to be brought in by Mr. Jimmy Dunnachie, Mr. Allen Adams, Mr. Jimmy Wray, Mr. Jimmy Hood, Mr. Alan Meale, Mr. John Hughes, Mr. Frank Cook, Mr. Don Dixon. Mr. George Galloway, Mr. Keith Vaz, Mr. Mike Watson and Mr. Frank Haynes.

BAN ON IMPORTS (CHILD LABOUR)

Mr. Jimmy Dunnachie accordingly presented a Bill to prohibit the sale of imported goods, the manufacture of which has involved child labour: and the same was read the First time; and ordered to be read a Second time on Friday 20 October, and to be printed. [Bill 198.]

Mr. Eric S. Heifer: On a point of order, Mr. Speaker. The hon. Member for Southampton, Test (Mr. Hill) throughout the speech of my hon. Friend the Member for Glasgow, Pollok (Mr. Dunnachie) was not just chunnering away, but was shouting out. He was making all sorts of remarks. I think that he said that it was a waste of the House's time. The hon. Gentleman should begin to learn some manners.

Mr. Speaker: I was listening carefully to what the hon. Member who moved the motion was saying. I did not hear anything else.

Opposition Day

18TH ALLOTTED DAY

Local Government Finance

Mr. Speaker: We now come to the first of the Opposition motions—that on the poll tax. I must announce to the House that I have selected the amendment in the name of the Prime Minister.

Dr. John Cunningham: I beg to move—[Interruption.] That is all very well, but we would like to see that right hon. Gentleman replaced with a Socialist Secretary of State.
I beg to move,
That this House rejects the unfair, inefficient, intrusive and bureaucratic poll tax, the so-called community charge, because the tax will bear most harshly on the poorest and weakest in the community, will discriminate against carers at home, will undermine and distort local accountability by concentrating an unprecedented 75 per cent. of local authority expenditure under Ministerial control, and is capricious and unfair in its effect on areas of the country with low rateable values; furthermore regards the proposed rebate system as mean and inadequate; recognises that the national business tax will cause grave financial problems for thousands of small business people; and calls upon Her Majesty's Government to abandon these proposals.
We already have evidence of those effects in Scotland.
Before I proceed, I want to congratulate the right hon. Gentleman the new Secretary of State on his major promotion. We know that he brings considerable intelligence and ability to a Department much in need. of both. However, what has been lacking in the Department of the Environment are not just those things, but good judgment and coherent principles to safeguard the environment, the essential public services and local democratic government.

Mr. Tony Banks: Will my hon. Friend remind the House of how many Environment Secretaries he has seen off since he has been Shadow Environment Secretary? How long does he think the new incumbent will last in his office before we have a Socialist Environment Secretary?

Dr. Cunningham: As I said earlier, it is all very well seeing off Tory Secretaries of State, but I am getting a little fed up with them being replaced by other Tories. Next time we want to replace not only the right hon. Gentleman, but all Members of the Treasury Front Bench.
The new Secretary of State and his new Minister for Local Government, the hon. Member for Wirral, West (Mr. Hunt), whom we also congratulate and welcome, must have at least some private misgivings, because they have inherited something of a shambles. The poll tax, water privatisation, the Government's failure adequately to safeguard the environment, both nationally and internationally, are, together with the threat to the National Health Service, the most deeply resented issues in British politics.
It is evident that no amount of repackaging or changes in personnel can possibly make the poll tax and water privatisations popular, or acceptable to the British people. Both are clearly seen as deeply unfair, inefficient and


damaging to families, to services such as education, and to the environment. Both are inconsistent with the widespread desire of the British people for a better quality of life.
Therefore, without fundamental changes in the policies themselves, the new Secretary of State faces just as rough a ride with his colleagues as his predecessor—indeed, an even tougher time, as the awful truth of the consequences of the poll tax and the national business tax on property dawn on the Tory party and the people.

Mr. Robin Squire: rose——

Dr. Cunningham: No, I shall not give way.
We shall, of course, miss the special and idiosyncratic presentational skills of the previous Secretary of State, whom we also wish well. Opposition Members take considerable pleasure in the knowledge that he is still on the loose, still on the Government Benches and free to range the country in an attempt to recover support for the Tories, much of it lost by his own policies at this Department in the first place. British industry has been remarkably and uncharacteristically silent about its new Secretary of State. We share its obvious misgivings about the future well-being of industrial policy, jobs and the economy.
Like his hon. Friends, we shall listen to the Secretary of State's speech with particular interest. Indeed, the Labour party chose this debate because we wanted to give him the earliest opportunity to announce the changes in policy that he envisages. We promise him a warm welcome.
The Secretary of State will know about the uproar in the Chamber last week about the poll tax—or the "Tory tax" as the right hon. Member for Henley (Mr. Heseltine) rightly calls it. That uproar was yet another sign of the fear that is spreading through the Tory party about the implications of the poll tax for them and their survival. Like us, I am sure that they too will be anxious, if not desperate, to hear about changes in policy, not just in personnel and presentation.
It was the predecessor of the Secretary of State who, with typical candour, blew the gaff on the Conservative Government's real intentions about the poll tax when he asked why a duke should pay more than a dustman. The implication is clear. The intention was to introduce a tax unrelated to income or to the ability to pay, and that is exactly what the Tory Government have done.
The people of Scotland have already been made to suffer, but they have reaped their revenge through the ballot box. The people of England and Wales will eventually do so too.

Sir Nicholas Bonsor: rose——

Dr. Cunningham: No, I shall not give way at the moment. We say that there are many reasons—equity, social justice and the principles of progressive taxation—why someone such as Lord King, the chairman of British Airways, with a reported salary of £386,000 per annum, should pay more than an engineering apprentice in his company with a take-home pay of between £65 and £85 per week. We know instinctively that it is grotesquely unfair to make them pay the same contribution in local taxation—[Interruption.]
Did I hear a Tory Member mutter something about rebates? Yesterday, I released up-to-date figures compiled by the statistical section of the Library, which showed the mean and inadequate rebates that would have been available if the poll tax had been in operation this year. Last week, the Department finally published its illustrative poll tax figures for 1989–90. Using the latest poll tax figures, I asked the statistical section of the Library to calculate for each local authority the maximum level of net weekly income at which poll tax rebate would be payable to single persons, married couples and pensioners.
The Government have always been afraid and unwilling to publish that information. The Social Security Act 1986 and the poll tax Act 1988 require everyone to pay at least 20 per cent. of the rates bill, regardless of their circumstances or ability to pay. That extremely unfair rule continues next year, when the poll tax comes into force on 1 April 1990 in England and Wales.

Dame Elaine Kellett-Bowman: Will the hon. Gentleman admit that, because the figures published in the document about the Labour party's proposed capital tax and local income tax showed how catastrophic they would be for the British public, the Labour party abandoned those policies?

Dr. Cunningham: No, I will not admit that, because it is not true. There has been no abandonment of policy. Nor did the previous Secretary of State for the Environment publish any realistic figures. The right hon. Gentleman told me in a note referred to in a parliamentary answer on 9 November 1987:
There is no comprehensive data available from which to assess the outcome of a capital revaluation of domestic rateable values, and it is not Government policy to undertake such a revaluation. Some insight into the possible effect of a revaluation on the basis of capital values can be obtained by considering the relationship between house prices and existing rateable values in England.
But the Department does not have the data. It was quite dishonest of the previous holder of that high office to fabricate the results.

The Secretary of State for the Environment (Mr. Chris Patten): I notice that the Leader of the Opposition said last week that the Opposition's policy needed sophisticating. Will the hon. Gentleman say when it is likely that their policy will be sophisticated enough to share with the rest of us?

Dr. Cunningham: We are sophisticating all our policies all the time. That is why there is such a large and growing gap in British public opinion about the relative merits of party policy. When we have finished our considerations of these matters, the Secretary of State will not be the first to know, and that will come as no surprise to him. However, his right hon. and hon. Friends are waiting to hear from him not about Labour party policy, but how he proposes to dig them out of the appalling mess that present Government policy has got them into in their constituencies. Let me illustrate how big that mess is.
Figures show that a single pensioner in the Prime Minister's Finchley constituency, would face a poll tax bill of £290 per person per annum and would lose all entitlement to rebate if his or her net income exceeded £72·50 per week. In other words, a pensioner with a net income of £73 per week would be expected to find £5·57 per week to pay the poll tax. In Bath, the constituency of the Secretary of State, a single pensioner faced with a poll


tax bill of £281 per year, according to the Government's figures, would lose all entitlement to rebate if his or her net income exceeded £71·60 per week.
A married couple with two children aged eight and 10 living in Finchley would lose all rebate if their net income exceeded £151 per week. In other words, they would have to find £11·15 per week just to pay their combined poll tax. A married couple with two children living in similar circumstances in the Secretary of State's constituency would lose all entitlement to rebate if their income exceeded £149·10 per week, and would have to find £10·81 per week to pay their combined poll tax bill.

Mr. John Marshall: rose——

Mr. Derek Conway: rose——

Dr. Cunningham: A single person under 25 living in Finchley would lose all entitlement to a rebate if his or her net income exceeded £58·80 per week, and nearly 10 per cent. would go towards the poll tax.
Those are the realistic implications of the impact of the poll tax on take-home pay, including the Government's current proposals for rebates. Those figures prove that all but the poorest face substantial additional tax burdens, with everyone required to pay the minimum 20 per cent. The tables show how little the rebates are related to the ability to pay or personal circumstances and are based on this Government tolerating scandalously low levels of pay and poverty.
The figures reinforce the conclusion of yesterday's Child Poverty Action Group report on poll tax benefits and the poor, which said:
The poll tax is intrinsically unfair—as a flat-rate tax, it falls equally on the shoulders of the rich and the poor. Even with the help of rebates it is poorly related to the ability to pay.
The inefficiencies of the poll tax are legion. Local government has already been faced with bills two to three times those for the collection of rates. At the annual conference of the Tory-dominated Association of District Councils, its leader, Tory councillor Roy Thomason, interrupted the then Secretary of State, the present Secretary of State for Trade and Industry, to say:
£200 million more, Secretary of State.
The then Secretary of State replied:
My advice to you is to find better ways of raising the community charge and try to make savings, rather than always complaining about not having enough money.
That answer was jeered to the rooftops by the Tory-dominated conference of the Association of District Councils.
Last week. there was a fiasco when the Government announced the so-called "safety nets". Howls of outrage from Tory Members rang round this Chamber, but in the main, they were only getting what they voted for in Division after Division, when, with a few honourable exceptions, they passed the legislation in the first place. The panic in the Tory party was astonishing.

Mr. Squire: As the hon. Gentleman and the House know, I come into the category he has just mentioned. If he is to beguile me to an alternative solution, he must—as I am sure he will—suggest one or more alternative ways in which we may proceed; otherwise, I may be convinced to follow my right hon. Friend the Secretary of State.

Dr. Cunningham: I recollect that the hon. Gentleman had his own alternative, which he tried to persuade his

ministerial colleagues to accept, without success. In the main, Tory Members voted for what they are getting, and their panic is astonishing. It exposes the reality that many of them apparently did not know what they were voting for.
The safety net financial allocations are as capricious as every other aspect of the poll tax. Their application has nothing to do with efficiency or otherwise. Tories in the north, especially the north-west and Yorkshire, want more grant for their often Labour-controlled authorities because they fear a political backlash. Tories in the south complain that their constituents will subsidise their colleagues' areas. Let us consider the reality.
Wandsworth, for example, a Tory borough, gains £46·4 million from the safety net system. Is Wandsworth inefficient? Is that what Conservative Members are saying? Is it a poor council? Or is there a political reason for that allocation? Birmingham, a Labour city, contributes £50·2 million. Birmingham certainly qualifies under the Tory definition of efficiency, yet Birmingham has huge problems in housing, employment and inner-city difficulties. It has had to adjust to a cumulative loss of more than £500 million in rate support grant alone under this Government. Yet the people of Birmingham, under the safety nets, are asked to contribute an additional £50·2 million to subsidise the poll tax.
Let us consider Westminster. Is that a well-run Tory council? The safety net effect adds £33 per adult to the poll tax of £428 in Westminster. Lady Porter's policy of "building stable communities", which was described by Tory councillor Mrs. Patricia Kirwan as "gerrymandering the electoral processes", will cost each poll tax payer in Westminster an extra £60 a year. Is Westminster efficient? Are any Conservative voices raised about what is going on there?
Copeland borough council in my own constituency, which, under Labour control, had no rates increases for seven years, gains £5·2 million from safety netting—equivalent to £94 poll tax per adult—but the average two-adult household in my constituency will still be £40 a year worse off under the poll tax than under the rating system. So much for Tory claims that people are benefiting.
We know that poll tax registration involves massive new and regrettable intrusions into people's privacy and family lives. Many councils are asking people to respond to questions that the registration officer has no right to ask in the first place. Breaches of the Data Protection Act 1984 have occurred, and more than 300 councils are being required by the Data Protection Registrar to account for the questions on their forms. I seriously ask the Secretary of State to go away and look at that problem and do something about it. Will the Government stop unnecessary, and in some cases unlawful, activity by poll tax registration officers?
Those problems were highlighted during our debates, but they were dismissed by the then Ministers.
I should like to know whether the Secretary of State intends to make any changes. Responsibility for the final level of poll tax charged will overwhelmingly rest with Ministers and not with councils, whatever their political control. Ministers will decide and control 75 per cent. of council income, and they have already begun to consider how they can gerrymander the situation.
In the controversial propaganda leaflet that was sent to every household earlier this year, the Government said:


Every council will decide the level of its community charge—just as it decides the rates now.
Of course, that statement is totally untrue. The leaflet goes on to mention the needs grant that each council will get. What the leaflet does not say is that the Secretary of State himself will decide how much each council needs to spend. His decisions could make hundreds of pounds of difference to the poll tax to be paid by almost every adult. That is what the system provides for.
The Opposition have a copy of the Government's working documents. For instance, one set of figures in front of the Secretary of State tells him that Birmingham needs to spend £627 million to provide a standard level of finance—to the Government's standards, that is. However, another figure tells the Secretary of State that Birmingham needs to spend £750 million to provide that same standard level. An analysis of the figures shows that the different formulae available for the Secretary of State to choose from could add over £3 a week to the poll tax for everyone in Birmingham. In almost every local authority, the situation and the effect are the same.
In Westminster, for example, the Secretary of State's choices could influence the poll tax by as much as £4·76 a week, in Kensington and Chelsea by £4·41 a week, in Wandsworth by about £3·70 a week, in Portsmouth by £2·20 a week, in Manchester by £3·40 a week, in Newcastle by £2·70 a week, and in Newham by as much as £5.40 a week. That is the Secretary of State's latitude, in addition to his 75 per cent. control, in determining exactly how much poll tax will be paid by people in towns and cities. It is nonsense to claim that that increases accountability and leaves more decision taking for local government. It does exactly the opposite.
The figures make a mockery of the Government's claims that high levels of poll tax are due to inefficiency or high spending. They demolish the argument that the poll tax will increase local accountability. Hundreds of pounds per person per year can be added to councils' bills by the Government and the figures that they decide to put into their computers.
From April 1990, Tory Ministers will control more than 75 per cent. of all local government income, an unprecedented state not only in Britain but in any western democracy. The Government's documents expose their determination to exercise even greater control over local government revenue raising. They show that the biggest influence on poll tax bills will be central Government policies and decisions, not local authority decisions taken in the communities.
For the increasingly large number of Tory Members who are now panicking, there is more bad news on the way. Last February, the Government announced their proposal for phasing in the combined effects of the nationalisation of business rate poundages and the first revaluation since 1973. Increases in business rate bills are planned to be restricted to 20 per cent. per annum plus inflation. Businesses gaining from the changes will have their benefits delayed. It all sounds remarkably like poll tax safety nets, and will have the same political effect when Tory Members and those business people active in local Conservative associations wake up to what is happening. An increase of 20 per cent. per annum plus inflation means rates bills going up by three times in five years.
Even five years of safety nets will not lead to the full introduction of the new business rate arrangement. Businesses in Tory areas in the south will find their poundages rising hugely. Government figures included with the poll tax calculations published on 19 July show that Kensington and Chelsea's business rate poundage will rise by 111·4 per cent., Wandsworth's by 60 per cent., Westminster's by 51 per cent., Redbridge's by 46 per cent., Bromley's by 43 per cent. and South Herefordshire's by 23 per cent. The revaluation will push up the figures even further. The combined effect of national business tax and revaluation in, for example, Kensington and Chelsea will have astronomical implications for the business rates that people will be expected to pay.
The Government are trying to cover up that unpalatable arithmetic. The new rateable values for every individual property must be deposited by the Inland Revenue with charging authorities by 31 December—yet the first that businesses will know about them, unless they or their advisers track them down in the town halls, will be when they receive the bills in March 1990. The Government hope that ratepayers will look only at the amount payable, restricted to an increase of 20 per cent. plus inflation, and not the eventual liability shown by the rateable value. Most business people will soon see through that. If Tory Members think that they are in trouble now because of the poll tax, let them wait until the facts of the new business tax come out.
A number of Conservative Members have asked about Labour party policy. For the expenditure of a modest 75p and a letter to Walworth road, they can have a copy of our document. We intend to introduce a modern property tax based on the capital value of a property, with up to 100 per cent. rebates for low-income families or those least able to pay; we will reduce the proportion of local taxes raised through property tax; we will dedicate an element of the income tax to local government; we will restore business rates as a local tax; we will return meaningful purpose to the statutory consultation between local authorities and local businesses; we will end the ever-changing and chaotic restrictions, penalties and cuts; and we will have annual elections for a part of every local authority.
That will provide for a local taxation system that is genuinely fair because it is directly related to the ability to pay. It will end the need for dramatic increases in local tax bills. It will restore the right of local people and their councillors to govern their communities and raise revenue free from central control. It will take account of the differences in resources of authorities in different parts of the country.

Mr. John Heddle (Mid-Staffordshire): Will the hon. Gentleman give way?

Dr. Cunningham: No.
The Cirencester besom has been replaced by the modern Tory technological broom, from arid Silk Cut dry to Blue Chip glistening wet. The Secretary of State comes with a record of rebelling against cuts in employment and housing benefit, being in favour of aid to the poorest and of incomes policy, and is described as the heir to the tradition of Macmillan and Macleod.

Mr. Heddle: rose——

Dr. Cunningham: The Secretary of State was co-author of the pamphlet by the Blue Chip Group, which argued


that the Prime Minister's economic policies were socially divisive and politically unworkable. He was vice-president of the Tory Reform Group. He has now been promoted to patron of the Tory Reform Group, the body which published a paper on the poll tax which said:
The Government's case for the community charge rests, above all, on achieving proper accountability. Yet this is precisely where it fails.
It said that the poll tax
shows every sign of being an administrative nightmare
and that the uniform business rate
will result in a massive increase in the centralisation of power.
Those are the views of the Tory Reform Group, of which we learn that the right hon. Gentleman is no longer a mere vice-president but a patron.
What has changed? Have his views changed, have the views of the Tory Reform Group changed, or have the Prime Minister's policies changed? If he was asked for his view yesterday, did he say with candour—candour which we know that he has in abundance—"Margaret, we have got it about as wrong as possible"? Or was it "as you were" with the policy?
The Secretary of State's problem is that the profoundly detested policies that he has inherited are the Prime Minister's own ideas. The policies have exceeded their shelf life. The ideas have passed their sell-by date and the British people will no longer buy them.
The flat-rate poll tax is a scandal which divides Britain from the rest of Europe and every other western democracy. The poll tax is unique to Britain; no other country in Europe has a tax that is so harsh, unfair and intrusive. The 24th amendment to the constitution of the United States of America rules out any connection between poll tax and citizenship. Churches, charities, voluntary organisations, businesses and many——

Mr. Roger King: We do not live in America. We live here.

Dr. Cunningham: Unfortunately, the hon. Gentleman does live here.
—leading Tories have all condemned the poll tax proposals, and the Labour party's protest campaign has informed and focused the overwhelming opposition of the British people.

Mr. Hill: Will the hon. Gentleman give way?

Dr. Cunningham: No.
But whatever the Secretary of State's message today, our message is clear: the poll tax will go when the Prime Minister and her Government go. There can be no future for such an iniquitous, unfair, inefficient and capricious tax. A Labour Government will abolish it.

The Secretary of State for the Environment (Mr. Chris Patten): I beg to move, to leave out from "House" to the end of the Question and add instead thereof:
supports the introduction of the community charge, the principles of which are manifestly fairer and simpler than those that now apply to domestic rates; welcomes the exemptions conferred on those who cannot be asked to pay and the generous discounts, rebates and increased income support available for those on low incomes; recognises that the unified business rating system introduces a valuable stability for non-domestic ratepayers; congratulates Her Majesty's Government on implementing proposals that will improve the accountability of local government by insisting

that all who benefit from their services should have a say in their quality and cost; and notes that either a local income tax or a two-tax system based upon local income tax and capital value tax would be much more expensive to implement, much more unfair and make local government much less accountable.
I shall begin as I am sure the hon. Member for Copeland (Dr. Cunningham) and I will go on. The hon. Gentleman paid me some very genial courtesies, and I return the compliment. As the House knows, the hon. Member for Copeland was a Labour moderate before it became compulsory. He was a moderate before anyone had heard the name of Peter Mandelson. As a result, he has always enjoyed the respect of the House. I realise that, for as long as the hon. Gentleman comes to the Opposition Dispatch Box, I shall always have my work cut out. Between the two of us—wild eyed fanatics that we both are—I am sure that we shall keep our debates within the bounds of sobriety and public decorum.
A combination of typical ministerial humility and concern for all right hon. and hon. Members who wish to participate in the debate persuades me to be brief. [Laughter.] I knew that the hon. Member for Copeland would believe that. It is always tiresome when Front Bench speakers take up too much time in short debates.
The burden of the comments that I have heard from Labour spokesmen, such as those made on television last night by the right hon. Member for Birmingham, Sparkbrook (Mr. Hattersley) and in the speech of the hon. Member for Copeland is—I shall try to be briefer than the hon. Gentleman managed to be—different man, same policy. Having listened to the comments of the hon. Member for Copeland, I have an overwhelming feeling that, had I been privileged to participate in earlier debates, I could say of him now—same man, same speech.
The House can be in little doubt that the hon. Member for Copeland does not care much for the Government's reform of local government finance, but he remains more than a trifle obscure on what he would do instead. There is an unfashionable degree of consensus on one particularly important point. On the Opposition, Conservative and Democrat Benches, there is agreement that the existing system of domestic rates must be replaced. The main reason why that must be done is that the domestic rating system is unfair. Whatever may have been the case in the 19th century, there is little relationship today between the rateable value of domestic property and the value of the services that individuals receive from their local authorities.
Still less is there much of a relationship in many cases between the value of a house or flat and the ability of its occupant to pay for local services. Moreover, the present system obscures the relationship between expenditure on services and payment for them. I shall deal with those points in more detail shortly.
I was not sure from the remarks of the hon. Member for Copeland, and from the Opposition's comments over the past few weeks, about their alternative. Sometimes they seem to have one, sometimes not. Today seemed to start as a have day, then it was a not day, and then a have day again. On have days—and perhaps this is one of them after all—it is suggested that about 80 per cent. of locally raised revenue should come from capital value rates. That would exacerbate the problems of the existing system. We all know well enough that an increase in the value of our house or flat does not mean that we can afford to pay more


for local authority services or for anything else. If that is true for most people, what about the retired, the widowed, and all those people living on fixed incomes?

Mr. David Winnick: Is the Secretary of State aware that the Select Committee on the Environment of the 1979 Session, which had a Conservative majority, totally rejected the poll tax as an alternative to the rating system? The poll tax was rejected also by one of the right hon. Gentleman's predecessors as Secretary of State for the Environment, the right hon. Member of Henley (Mr. Heseltine). May we take it that the Secretary of State is enthusiastic about the poll tax as an alternative to the existing rating system?

Mr. Patten: My memory of past Environment Select Committee reports is clearly not as extensive as the hon. Gentleman's. What I do recall is that I, along with my right hon. and hon. Friends, have fought two elections arguing the case for a community charge, and that we won those elections with what can only be described as comfortable majorities.

Mr. Brian Wilson: If the Secretary of State is going to cling to this policy, may I suggest that he learns his history a little better? Is he not aware that a White Paper in 1982 specifically rejected the idea of a poll tax, on the grounds that it was unworkable and unfair? Does he recollect that the Government went into the 1983 general election making no mention of a poll tax, and—again—specifically rejecting the possibility of one?

Mr. Patten: indicated dissent.

Mr. Wilson: It is no use the Secretary of State shaking his head. The poll tax was invented in panic after revaluations in Scotland in 1984. Does the right hon. Gentleman not accept that it is both paradoxical and an insult to his own intelligence that he should start his speech by congratulating my hon. Friend the Member for Copeland (Dr. Cunningham) on his moderation and then—apparently—give notice that he is going to accept uncritically the most extreme and offensive of the Government's policies?

Mr. Patten: That intervention suggests that we should not give way in debates such as this as often as we would like. Let me point out to the hon. Gentleman—I know perhaps even more than he does about these matters—that we began to advocate the abolition of domestic rates in 1974, and included that view in our election manifesto. [Interruption.]

Dr. Cunningham: I am grateful to the Secretary of State for giving way. I do not give way to hon. Members who sit and shout abuse during debates.
The Secretary of State does not seem to have a very clear grasp of the chronology of policy development in his own party. Is he not aware that his right hon. Friend the Member for Henley (Mr. Heseltine) has gone on record, as have his supporters, as making it clear that he worked with all his might and main to ensure that no mention was made of the poll tax in the Tory party's 1983 manifesto?

Mr. Patten: Whatever our disputes about the history of Conservative manifestos, I think that even the hon.

Gentleman will concede that there was a clear mention of the community charge in our last manifesto. If it will suit him, I will settle for one example: the majority that we won in the last election, which we fought on the community charge.
I was pointing out that capital-value rates, as advocated by Opposition Members—coupled with a local income tax—would not be fair or administratively simple; nor would they overcome the lack of accountability to the electorate. That is one of the great drawbacks of the existing system. I know that the Opposition have criticised us for allegedly distorting their policy and its effects, but I am prepared to do a deal, and I hope that the hon. Gentleman will consider it fair. If the Opposition will tell us clearly exactly what their policy is, and the assumptions on which it is based, we shall be willing to work out with them a fair comparison of our proposals and theirs. I do not think that anything could be fairer than that.

Dr. Cunningham: The Secretary of State's predecessor made the same offer. The right hon. Member for Cirencester and Tewksbury (Mr. Ridley), however, was not aware that I had already tabled a parliamentary question asking him to do just that. When we are ready, we will ask the Secretary of State to do it, but as he wants to avoid distorting the implications of our policy, why does he not consult the Institute for Fiscal Studies? The Sunday Times—not, incidentally, a known supporter of the Labour party—invited the institute to examine our proposals, and this is what it reported:
Smith found that Mr and Mrs Average, a couple with children, and an income of £13,000 a year, could expect to pay a total of £394 a year in poll tax, but only £363 under Labour's plan.
In other words, they would do better under Labour.
The Rating and Valuation Association has also carried out studies, which conclude that our proposals are not only fairer but more efficient than the poll tax. Why does the Secretary of State not read those?

Mr. Patten: The hon. Gentleman had better have a word with his right hon. Friend the Leader of the Opposition, who only last week told the hon. Gentleman and others that their policy needed sophisticating, as it was not quite right. When the hon. Gentleman has finished his sophisticating, and has put his policy in place, we shall be happy to look at it. I hope that, when we do so, the hon. Gentleman and other Opposition Members will not complain as they did last week when we present the House with the consequences.

Mr. Matthew Taylor: rose——

Mr. Patten: I have already given way as many times as the hon. Member for Copeland, and I wish to get on.
There are three main attacks in the motion and the hon. Gentleman's speech. We are told that the new arrangements are unfair, undemocratic and unworkable. We all know that domestic rates are an unfair tax on property. They are paid for by only half the adult population. They take no account of the number of adults living in a house, and there is a poor fit between the rateable value of a property and the income of its occupants. Four out of 10 people in above-average rated properties have below-average incomes. By contrast, the community charge is fairer, simpler and more honest. It is based on people rather than property, and for the first time


it will be paid by almost all adults. The charge will share the cost of paying for local council services more widely and fairly, but people will not all pay the same bill.

Rev. Martin Smyth: I welcome the Secretary of State to his new position. He has served in Northern Ireland in the past. Can he enlighten us as to why the boon has not been extended to Northern Ireland? Is it because, in the past, we believed that those who paid rates had a responsibility to take part in local authorities?

Mr. Patten: I had some responsibility for local government in Northern Ireland a few years ago. As the hon. Gentleman will know, local government in Northern Ireland, for a variety of historical reasons with which the hon. Gentleman will disagree, has different functions and responsibilities from local government in this country. If the hon. Gentleman would like the community charge to be introduced in Northern Ireland, he will be able to pursue that in conversations with the responsible Minister in the Northern Ireland Office.
As I have said, people will not all pay the same bill. The rebate system that we are introducing offers help where it is most needed—among those with low incomes or no income at all. It is more generous than the present system of rate rebates. Taking the arrangements for the community charge and the rebate together, it is worth noting that one in four charge payers will receive a rebate. I am extremely concerned that those who need help should receive it. I am asking my officials, as a matter of urgency, to review the arrangements we are making to maximise the take-up of rebates.
For 5 million people, the continuation of the maximum rebate and the uprating of income support, which has already taken place, will mean that, unless they live under a very high-spending authority, they will not be paying anything extra in community charge. Indeed, they may well be a little in pocket.

Mr. James Hill: When my right hon. Friend is listening to the selective figures from the hon. Member for Copeland (Dr. Cunningham) will he give the figures for Southampton, which are extremely favourable to a city of 250,000 people? At the same time, will he try to get out of the Opposition Front Bench spokesmen their policy to take over from the poll tax?

Mr. Patten: I am afraid that my knowledge of the position in Southampton is not as encyclopaedic as my hon. Friend's. I will encourage my hon. Friend who will reply to the debate to refer to those figures. Widows, single-parent families and others who are hard hit by rates in particular areas will be more fairly treated.
The next plank of the argument advanced by the hon. Member for Copeland is that there is something undemocratic about the new arrangements. There is certainly something deeply undemocratic about the present system. Only half the local electorate pay for the services enjoyed by us all.

Mr. Allan Roberts: Why does the Secretary of State continue with the myth that, because there are only half as many rate bills as poll tax bills, only half as many people contribute? Do not all members of his household, like all other households, contribute to the rates bill? I assure the right hon. Gentleman that in my constituency,

if a son is working, he contributes to the rates bill and if a wife has an income, she contributes to the bill—all the family pay the rate bill.

Mr. Patten: That is not the criticism that has been put and believed widely by those who have argued against the domestic rating system for many years—certainly at every election that I have ever fought.
We have seen the results of undemocratic weaknesses in many parts of local government, particularly in some inner-city areas governed by the extremist councillors that the Labour party tries to keep under wraps. We have seen sky-high rates for domestic ratepayers; businesses and jobs chased away from where they are needed as a result of rocketing business rates; and waste, inefficiency and extravagance in local authority budgets, contributing to an ever-increasing burden on the few who pay rates.
Under our system, there will be a simple link between the cost of services that an authority chooses to provide and the level of the community charge. People can decide what they think about the quality and cost of those services. The community charge bill will show this crucial relationship in the clearest possible way. Every pound per adult that an authority chooses to spend above the standard level of service will mean £1 extra on the community charge bill. Equally, every £1 per adult saved feeds through to £1 off the bill. That is a major improvement in local accountability and democracy. It gives a clear choice about the cost of local authority policies, which is precisely what the Labour party is so concerned about. The community charge puts I he community in charge.
The other argument that we hear from the Opposition is that the new arrangements are complicated and unworkable. The hon. Member for Copeland referred to a scare story and to invasion of privacy. The legislation was drafted specifically to limit the amount of information for which registration officers can ask. We give specific advice, which we agreed with the local authority associations and the Data Protection Registrar, on the registration form. Some registration officers went beyond that and, quite properly, were pulled up short by the registrar. I hope that they will listen to our advice.

Dr. Cunningham: This is one of the few points of debate on which there is some agreement. That statement has been made previously by Ministers, but it seems to have gone unheeded. Why does not the Department take action by writing to community charge registration officers or issuing notes for guidance to stop this practice, which is an unnecessary invasion of people's privacy and, in some cases, is illegal? I assume that there is no party political dispute about that matter at least.

Mr. Patten: As the hon. Gentleman knows, we have issued guidance. I am certainly prepared to consider whether there is a case for further guidance, because I agree with the hon. Gentleman that in some cases registration officers have gone beyond what the law should have allowed.
It would be remarkable if a system that abolished rates and introduced a long overdue reform of local government finance could be achieved without some disadvantage to some people. Without undermining the principles on which this reform is based, we shall continue to do all we


can to smooth the transition. Much of the recent discussion about the new system has, understandably, concentrated on the safety net.
The changes that are coming next April are substantial. We are moving from a discredited system under which grant is distributed largely on the basis of rateable values to a fairer system. Inevitably, whenever there is change, some people benefit but others are worse off.
One of the main changes is the ending of resource equalisation. That has meant in practice that grant is taken from areas with high rateable values and directed towards areas with low rateable values. This might be a sensible basis for paying grant, but only if one accepts that rateable values are a fair basis for local taxation. As I have explained, that is not the case. With the move to the community charge, we are doing away with that cross-subsidy. It is a cross-subsidy of which few people are aware. It illustrates one of the problems of lack of accountability in the present system.
Councils providing the same level of service will in future be able to set the same community charge. If we had not introduced the new system, those authorities contributing to resource equalisation would have had to continue to pay that back-door cross-subsidy indefinitely. We shall do away with that unfairness.
The issue is how fast we can move to the new system. Some of my hon. Friends want us to move the whole way immediately. They represent those who have been paying the burden of resource equalisation in the past. They want to get rid of it now. I appreciate their concern, but it would not be easy to move to the new system overnight, and what my right hon. Friend proposed last week makes a big start towards phasing out a penalty and phasing in a gain.
Those areas which have traditionally benefited from resource equalisation need a period, however short, to adjust to the new circumstances. Other hon. Members representing those parts of the country have stressed that they need time for people to adjust to the withdrawal of the hidden subsidy. We have, first, made the system explicit. No longer will there be disguised cross-subsidy in the grant system. But we have proposed a temporary safety net which is separately identifiable and which makes clear what is happening.
Secondly, we have nearly halved the amount which contributors will have to pay to the safety net. Over 200 authorities will be better off as a result of the change. They will now pay 40 to 50 per cent. less in the first year than they would have paid under the old safety net proposal. That is significant progress.
I wish to make it absolutely plain that I shall look carefully at the points that were made when my right hon. Friend the Member for Cirencester and Tewkesbury (Mr. Ridley) made his statement on local government finance last week. Naturally, some would like to go faster, with more of the gains coming through immediately. Others would wish to go more slowly, giving greater protection to the losers. I am not sure whether that circle can be squared, but I shall pay the closest attention to what is said in this debate and in future discussions.
I come to these issues relatively new. The hon. Member for Copeland made that point. I recognise that there will be many further exchanges across the Floor of the House before the charge is brought in next spring. I shall of

course want to listen to any helpful suggestions on how we might make the transition as easy as possible. It would also be a welcome change to hear from Opposition Members—perhaps we have been making progress today; a bit here and a bit there—precisely what they would do, sophisticated or perhaps not so sophisticated.
For our part, we shall continue to press ahead with the introduction of this reform, whatever the kebabing tactics of the Opposition. We shall press ahead for the reasons set out in our amendment to the motion, and I urge the House, for the reasons there set out, to vote with us at the conclusion of the debate.

Mr. Dick Douglas: I listened to the maiden speech by the new Secretary of State for the Environment, the right hon. Member for Bath (Mr. Patten), with great interest. I congratulate the right hon. Gentleman on his appointment. I have known him for some time in the House. I met him first as a colleague on the Select Committee on Defence, and I recognise his outstanding ability to grasp, and master, issues. I do not think that he needs to excuse himself if he finds this issue difficult to grasp.
I caution him that he does not need to look at the crystal ball—in Scotland we have the book. The poll tax books are coming through the door. Some of the three-monthly payments are due right now. Nice little letters come through the door to remind us that, if we do not pay for the three months, the whole year will become due.
I caution the Secretary of State because I think that he, is a fair man. He comes from overseas development, where he considered the world situation. It was his responsibility to attempt to transfer resources from the richer nations to the poorer nations. An outstanding example of that was his experience in Nepal. We know that because the Select Committee on Defence went there and because of our exchanges with him.
I shall give a graphic illustration of the effect of the poll tax. An old man, aged 90, in my constituency told me that he and his wife, aged 88, have £6,000 in the bank. They pay two poll taxes. He asked, "Dick, my boy, does that mean that I will have to pay the same as the Earl of Elgin?" I told him, "Aye, that's the law." In God's name, is that fair? How can one say honestly that someone who has taken notice of the credos of the Tories, who has been careful and has built up a capital sum, should pay two poll taxes?
An old lady moved about 200 yards down the road to look after her mother, aged 90. The law says that she is now resident there and they will have to pay two poll taxes there and two poll taxes at the standard charge rate for the house that she has vacated. Instead of paying about £800 in rates, they are paying £1,200. How in God's name is that fair?
We have a tax on property. Does the Secretary of State not know that the standard charge is a tax on property? I part company with many of my hon. Friends on many issues, but I think that, in a system of taxation which is multi-based, there is no reason for excusing property. Everything else is taxed, so why in heaven's name is there a case for exempting property? That is what the Tories have tried to do, however, on the basis of accountability.
If one wants to evade accountability for looking after old people properly within the community, what does one


do? Put them in a hospital, or a nursing home, where they do not pay any poll tax. Have them in the bosom of the family, however, and they will pay the tax. How in God's name can that be defended in a civilised society which prides itself on trying to look after elderly people?

Dr. Norman A. Godman: In their constituency surgeries, Scottish Members have come across people who have been crippled by the poll tax. Does my hon. Friend agree that, yesterday, we saw a plain reaction to the Scottish poll tax in the resignation of the right hon. Member for Ayr (Mr. Younger)? Does he also agree that the right hon. Gentleman's resignation shows plainly that he and others in Ayr have given up hope of the Conservatives retaining that seat, because of this and other legislation?

Mr. Douglas: I will not digress too much.
The Secretary of State has had experience of Northern Ireland. There is no way the Government would try to introduce the poll tax in Northern Ireland without first putting it in their manifesto, but they did that in Scotland. They put it into practice without it being in the manifesto and the Scottish people have pronounced on it—we have voted on it.
I ask the Secretary of State to give me his attention and not to talk to the hon. Member for Salisbury (Mr. Key), who is trying to get his ear.
In Scotland, we pronounced on the poll tax. Accountability is the argument for the poll tax, but the only part of the United Kingdom that had the poll tax in 1987 was Scotland, and the Scottish people overwhelmingly rejected it.
The Secretary of State should not look at a crystal ball when he can read the book. He should consult his colleague, the Secretary of State for Scotland and, in a moment of reasonable quietude, perhaps achieve some understanding of what is happening there. Many people are paying poll tax, but many others, like me, are not. We will accept the odium.
I notice that people in certain parts of England have achieved a change of Secretary of State by burning an effigy of the right hon. Gentleman's predecessor. I wholly disapprove of that practice. I think that it is more illegal, and more of an incitement to bad behaviour, to burn an effigy of the right hon. Gentleman than to say there is a basic right in a civilised society to object, through civil disobedience, to the imposition of an unfair and unjust tax that has been rejected by our people in a democratic ballot. What can we do if they do not listen?
The Secretary of State's closing remarks showed, although it is early days, that he is looking at ways in which the safety net can be shaded. I think that a large proportion, if not all of the safety net, will be borne by the Exchequer.
We came first in Scotland and the Scottish people inherently and instinctively resent being made the guinea pig for legislation which cannot work in any part of the United Kingdom and is certainly not working in Scotland.
I do not know what the figure will be—whether we will have 500,000 non-payers by August—and I cannot predict it, but I predict that it will be substantial. That underlines the fact that payment has brought about an enormous amount of resentment, which has been added to by behaviour in this House last week such as when the right hon. Member for Brent, North (Sir R. Boyson) who,

although he is a supporter of the poll tax, said that he resented the way that the safety net has been arranged. Also, for the first time in the British media we have seen resentment at the poll tax.
Last year, I ran all the way from Edinburgh to London to protest against the poll tax. I shall continue to protest. This is a marathon race that has been taken up by Opposition Members. We do not intend to renege on that. We will go the distance until the poll tax legislation is removed from the statute book, because it is unfair and unjust, and does not do what the Government have suggested it does. It is unfavourable to the poorer sections of the population and to those sections of the population who ought to be cossetted—the sick and the mentally handicapped. Those people ought to be assisted.
I have sufficient faith in the right hon. Gentleman's background—I will not dwell on his religious upbringing—to believe that, when he examines the matter, there will be adjustments, but they should come in Scotland first. The ideal solution is to remove the legislation from the statute book.

Sir Rhodes Boyson: I recognise the time constraints in this important debate, but I should like first to welcome my right hon. Friend the Member for Bath (Mr. Patten) to the Dispatch Box as Secretary of State for the Environment. We served together in the Northern Ireland Office, and I am sure that he will do an excellent job in charge of the Department of the Environment. It is an important portfolio. I welcome also my hon. Friend the Member for Wirral, West (Mr. Hunt) to his new portfolio—because he will reply to the debate, I have tried to win his favour before deploying my arguments.
First, I believe in effective local government. I do not want power to be centralised, because liberty comes from a balance of power. I spent 10 years in local government and I do not want local government to be stripped of its powers. Over the past 20 years, local government has been threatened because often the majority party in local government differed from the party in government, so they do not have much time for each other. The danger is that the party in control may ride roughshod over the other party.
Secondly, I believe in the community charge. There is a straight difference of opinion between the two sides of the Chamber on this matter, but I believe that people should pay at least something towards what they vote for. That is what responsible government is about. We can argue about the amount that people should pay and about the amount of rebates.
It has been said that people pay as part of a family, but in some parts of the country only one in four of the people on the register pay rates, compared with one in three and one in two in other areas. That is wrong. There is an incentive to increase expenditure when some people can vote to spend other people's money. As a northern nonconformist, I believe that there is no political morality in that. I welcome the community charge as a means of bringing political responsibility into local government voting.
We have frequently heard about the peasants' revolt. Their revolt was basically against the oppressions of the feudal controls on the labour market. I would argue that that was a Thatcherite revolution. If I had met Wat Tyler


on his way to London bridge, I think that I could have made him a member of the Brent, North Conservative association. His supporters wanted a free labour market. If they were marching on us today, I believe that there would be more of their supporters sitting on the Conservative Benches than on the Opposition Benches.
Thirdly, the present method of funding the safety net is immoral and is political suicide for the Conservative party. The idea of transferring money over four years from the heavy community charges levied on careful Conservative areas to spendthrift Labour authorities is unsaleable in Conservative areas. That will take place over a full four-year cycle of local government elections in England and Wales, over a general election and within one month of the next European election. All that time, electors in prudent areas will see that they are transferring through their community charge £25, £50 or £75 per person per year to areas that have more amenities because they have spent more money.
About a fortnight ago, a list that I compiled was printed in, I think, The Times. I referred to 25 Conservative seats in which all the constituents were to transfer considerable sums through the community charge over four years to largely Labour areas, yet the majority vote in favour of the main party was less than 5,500 in each constituency. This matter will be raised repeatedly in those constituencies.

Dr. Godman: Shame.

Sir Rhodes Boyson: There is no shame in it. Those authorities made a decision to be prudent—the shame lies with those who have wasted the money. The shame is that people in prudent areas have to pay for someone else's waste of money. I am grateful to the hon. Gentleman for allowing me to bring in a moral point. This is a dangerous and indefensible action.
Fourthly, I believe that a safety net so funded will break the morale of many good Conservative authorities. The hon. Member for Copeland (Dr. Cunningham) referred to Wandsworth. It was Thatcherite before Thatcherism, John the Baptist before anyone else came along. My hon. Friend the Member for Southampton, lichen (Mr. Chope), who I believe is still in the Department of the Environment—it is difficult to keep up with everything that is happening—made his name in Wandsworth by being a Thatcherite and bringing down expenditure.
The average rates bill per household in Tower Hamlets is £500, compared with £360 in Wandsworth. Tower Hamlets is usually Labour—controlled but at present is under the control of the Liberals-most hon. Members on both sides of the house, except perhaps the hon. Member for Truro (Mr. Taylor), hope that that is only temporary. After the calculations on the community charge and safety net have been made and the money has been passed back and forth, an individual in Tower Hamlets will pay £153 and an individual in Wandsworth £148. That is the result after all the efforts over the past 15 years in Wandsworth to build up a Conservative careful authority, which documents such as "Good Council Guide: Wandsworth 1978–87" have made famous. It is a green-coloured document, which shows that the council was going green at that time and knew what would happen to the Department of the Environment.

Mr. Matthew Taylor: Will the right hon. Gentleman give way?

Sir Rhodes Boyson: I shall give way when I have finished this point. We must go through paragraph by paragraph—it is much tighter and neater that way. It is like writing essays—we must do it properly.
After all that time, people in Wandsworth will be only £5 better off than people in Tower Hamlets. That is why I believe that this proposal will destroy the morale of many Conservative authorities.
I shall now give way to the hon. Member for Truro, as long as he makes just an intervention, not a speech.

Mr. Taylor: I hope that the right hon. Gentleman accepts that there are differences between Tower Hamlets and Wandsworth in terms of, for example, housing pressure. Tower Hamlets has large immigrant communities moving in, unlike Wandsworth. I think that all hon. Members accept that point. I hope that the right hon. Gentleman welcomes the fact that Tower Hamlets, under the Liberal Democrats, has cut rates.

Sir Rhodes Boyson: For the hon. Gentleman's benefit, I shall repeat my point. Wandsworth will compare the old rates and the new community charge and ask what it has done over those 15 years. I stand by what I say, whether or not the hon. Gentleman agrees with me.
Fifthly, the safety net is a strange formula. I spent nine months as Minister for Local Government. I always wondered where the calculations came from, where we changed them and what the computers did. Sometimes I felt that there were satanic demons, or gremlins, in the basement and, after we had all gone home, they moved the computers around. I believe that they have now moved up the stairs and are coming out.
I am sorry that the hon. Members for Brent, East (Mr. Livingstone) and for Brent, South (Mr. Boateng) are not in the Chamber. Using the straightforward community charge, people in Brent will have to pay the second highest amount in the country—£561 per person, according to the projected figures. The safety net was supposed to give councils a chance to get it right, but Brent will have to transfer £36 per person per year to other overspending authorities. Anyone who can defend that should be a member of the Magic Circle and performing at the London Palladium.

Mr. John Marshall: Does my right hon. Friend accept that many people in the Department of the Environment and elsewhere believe that Brent Council, as presently constituted, is beyond redemption?

Sir Rhodes Boyson: I must not get into a religious argument with my hon. Friend, for whom I have great respect, but I believe in the saving of souls and the redemption of all men. It seems that I may have cross-party support on that.
My sixth point is that, if there is to be a safety net, the money must come from the Treasury. It must not come from the good authorities, because that makes a farce of the community charge and destroys the whole basis of the new arrangements. If my right hon. Friend the Secretary of State wants to retain the safety net—and that is his right as Secretary of State—the Treasury must pay the lot. We do not want all kinds of formulas that we cannot understand; we have had too many of those from the Department of the Environment already.
We are told that £630 million will be needed next year to cover the safety net. If my right hon. Friend the Secretary of State comes back in October and says, "My right hon. Friend the Member for Brent, North can sit at ease; he does not need to intervene because I have got hold of the £630 million," I shall decide that his is the best of the recent appointments. He will command my support on almost every other issue—that is a dangerous thing to say—for as long as he and I are still battling in the Chamber.
Consider what a headmaster would do. If 10 boys broke 10 windows in my school, I would charge the 10 boys, as would all old schoolmasters; even Scottish dominies would charge the boys, and it would be for the boys to decide how to raise the money. The last thing I would do would be to say to those 10 boys, "Go away. You have done nothing wrong," and then call the rest of the school together and say, "You are paying for the 10 windows." There would be a riot in the school, and there is no doubt in my mind that when Conservative voters find that they are paying for windows, as it were, that others have broken, there will be a riot in the constituencies.
I shall vote against the Opposition motion this evening, for the simple reason that there is a new Secretary of State in whom I have great faith. Earlier, we were talking in religious terms. I am not suggesting that my right hon. Friend should move mountains; I just want him to remove the safety net. That will do for me at the moment. My right hon. Friend can move mountaains later as part of the Department's activities on the green side, but on the local government side, all I want is for the safety net to be removed.
If, by the time we next debate the safety net in the House, it has not been announced that it will be financed from Treasury money, I shall certainly vote against it. I am not putting the Secretary of State on probation. I have total faith in him and I know that he will solve the problem—[Interruption.] I must not argue with the hon. Member for Dunfermline, West (Mr. Douglas). I am sorry that no Treasury Minister is here to listen to what I, at least, believe to be words of wisdom. On the day when we discover that the safety net is to be funded by the Treasury, a cheer will go up throughout the country. I look forward to that day arriving before we reassemble after the recess.

Mr. Matthew Taylor: I join in welcoming the Secretary of State to his new role. There has certainly been a change of image. The only thing that I would say to him—I am sure that others have given him this advice—is that the quality of the salesman will not make up for duff goods. The fact that we have already heard criticisms from Conservative Back-Bench Members, mollified only by his newness and not by his remarks, is a sign of the difficulties that he may experience in his new role. I wish him luck, however, and I hope that we see some changes in practice as well as in presentation.
The poll tax is the most unpopular measure to have come from this Government so far. I say "so far" because it has had to jostle for its place with other measures. Later this evening I shall refer in an Adjournment debate to the reform of the National Health Service, and I think that the Bill containing the proposals for that reform may topple the community charge as the most unpopular measure when it is introduced in the autumn.
I am afraid that we are past the point at which we can expect Ministers—under this Prime Minister at least—to say, "We got it wrong. We shall change the provisions fundamentally." Ministers have committed themselves to the proposal. I suspect that, when the Prime Minister interviewed replacements for the previous Secretary of State, she checked that they were not likely to rock the boat. I can imagine her asking the current Secretary of State some questions: "You are patron of this organisation the Tory Reform Group. You don't really mean it, do you? You are there as a figurehead, are you not? I am sure that you do not stand by what that body says and that you would not want to have to take responsibility for it. You would not agree with its members any longer, would you?" I can imagine the right hon. Gentleman thinking about it, but not very hard, and deciding that perhaps he could sell the required message. With a change of Prime Minister or a change of Government, perhaps the right hon. Gentleman will get the chance to do otherwise.
This debate allows us a moment of reflection, and it is to be hoped that it will allow the new Secretary of State to consider changes that he may be able to introduce even under a Prime Minister who has an iron will and dislikes deviation from the set course. I was pleased to hear at least one Conservative Member speak up from the Back Benches. I was particularly pleased that the right hon. Member for Brent, North (Sir R. Boyson) pressed for change by calling for Treasury cash. The great error that the former Secretary of State made when he addressed I he House last week was to try to reconcile the irreconcilable by telling those whom he had previously said needed help and support that they would get a little less, to help those whom he had said were getting more than they deserved. That was not an easy concept to sell, and he failed to sell it. If a safety net is needed, it should be funded by the Treasury, not by calling on other local authorities to step in merely to suit the Treasury's other financial aims.
The debate has been called so that we can consider the effects of the poll tax on ordinary people. One thing seems certain: As with so many measures that have been introduced under this Government, the effect of the poll tax will be to hit the poor and advantage the rich—in. particular, to hit the old and the young——

Mr. John Marshall: Will the hon. Gentleman give way?

Mr. Taylor: I shall give way in a moment, when I have had the chance to develop my argument.
The community charge will affect most those just above the level at which one can claim supplementary benefit, who may have to pay the full poll tax. Equally, because the income support increase to help people pay the poll tax is based on the national average charge, people who live in areas of high poll tax—which tend to be the most deprived areas—will lose most. The living standards of those on low incomes will inevitably be adversely affected by the poll tax.
The analysis by the Child Poverty Action Group gives us evidence to support that. It considered the effect of the poll tax on the living standards of poor and middle-income families. I am sure that the new Secretary of State has recently been briefed on this. He will know that, overall, 63 per cent. of tax units will lose by the poll tax and 37 per cent. will gain.

Mr. Dave Nellist: Tax units? Does the hon. Gentleman mean people?

Mr. Taylor: We are talking not about individuals but about families paying tax—or tax units—63 per cent. of which will lose and 37 per cent. of which will gain.
The key figure to which the Child Poverty Action Group draws attention is this. Of the bottom range of taxpayers, 83 per cent. will lose and only 16 per cent. will gain, and the average loss involved will be more than £1 a week. In contrast to that, of the top range taxpayers—the very rich—71 per cent. will gain and 29 per cent. will lose. That is an almost complete reversal of the figures for the population as a whole. That is why I say that the poor will incur the losses and the rich will gain the advantage.

Mr. John Marshall: The hon. Gentleman said that the old would suffer under the community charge. Does he agree that 90 per cent. of single pensioners will be better off under the community charge?

Mr. Taylor: I do not agree with that figure. Some single pensioners will gain, but not 90 per cent. of them. They might also gain under other systems. That is an argument against the rates, but not for the poll tax.
Combined with the changes in social security benefits, the poll tax will be a particularly bad deal for the worse-off in society. That is hardly a more equitable system than the rates. The two changes mean that families, with children who have a net income of less than £75 a week—which is a third of all families with children—will lose between £4·88 and £5·01 a week. I know that the Prime Minister does not believe in society, but I thought that she and her Ministers made a virtue of supporting family life. These changes will make life harder for families, and there is no justice in that.
This weekend I was approached by a pensioner in my constituency who lives in a residential care home and will be exempt from the poll tax. Did she congratulate the Government on exempting her? No. She said that she did not understand why those being cared for by their families at home should be penalised for the privilege, while she was exempt. She wondered whether the Government really intended to force people into residential care homes. She did not criticise the Government's treatment of her—she understood why people might wish to be cared for in residential homes—but she could not understand why the Government wanted to create a financial incentive to take people out of the family home and put them into care, no matter how good the care was.
The Secretary of State referred to the difficulties of taking up means-tested benefits and said that he would seek ways to alleviate them. I wonder whether much can be done within the present system of rebates. In Scotland, the take-up of rebates by people on low incomes is extremely low. In some areas, it is as low as 25 per cent. The Secretary of State was right to highlight the difficulties. I am not convinced that, under the poll tax and the cumbersome system of rebates and help that goes with it to make it workable, the Secretary of State will be able to achieve his objectives. It is good to hear a Government spokesman speak in favour of helping people to claim the money, but the Government do not have much chance of succeeding in that. Time will tell, but I believe that our fears will be proved correct.
The implications of the poll tax for civil liberties cause great anxiety. It brings with it wide and intrusive powers

to establish and maintain the register and to enforce payment. Only today, I heard about an example in Rochdale which illustrates the problems of enforcing the poll tax. It is not an extreme example, but it illustrates the effect on people's daily lives, which is unnecessary and would not have arisen if the Government had not insisted on introducing the system.
Since last Friday, 33 canvassers have been calling at homes in Rochdale at 8.30 pm or at weekends to chase people about their poll tax registration. It is bad enough to approach people at a time of day when they cannot telephone anyone to advise them on their rights, but to call on the elderly and infirm at 8.30 pm is to frighten them. That is not simply because they are frightened of officials, but in some cases any unannounced caller at 8.30 pm causes fear and anxiety. Such calls would not be necessary but for the cumbersome nature of the system of taxation that the Government have chosen to introduce.
The effects of the uniform business rate are mentioned in the Labour party motion. Non-domestic rates currently raise more than domestic rates. The new rate will be set nationally, yet Ministers talk about the need for more local control and accountability and a greater link between people and their local authority and between businesses and their local authority. Ministers should be aware that the uniform business rate breaks the link. Deprived of locally raised non-domestic rate revenue, local authorities will depend on central Government for about 75 to 80 per cent. of their funding. So much for the supposed increased accountability of the poll tax.
The uniform business rate will penalise local businesses in areas where local authorities have done most to help them by keeping rates down and spending money sensibly. Businesses in my constituency are being asked to pay increases in their rates, in some cases massive increases, to fund local authorities elsewhere which in the past set high rates and provided more services. They are being asked to pay a considerable increase without seeing an improvement in local services in an area already acknowledged to be deprived and where incomes are almost 20 per cent. lower than the national average. We have more small local businesses than almost any other area. They thought that the Government were on the side of businesses, but they are penalising them.
As shop owners discover the effects on their business of this change, combined with the effects of revaluation and a wholly inadequate system of safety nets, they will go bust and change their vote. They will wish that they had not left it so late to change their allegiances.
In Truro, small shop owners paying rates of £767 will be shocked to see them rise to £1,750 over five years. That is an increase of 128 per cent., allowing for an inflation rate of 7 per cent. The bill of another retail outlet that we looked at would rise from £810 to £2,100. That is because the Government will not acknowledge their responsibility to support businesses. They are simply breaking local contracts.
The poll tax has been completely discredited. My party has never defended the rating system. For years, we have advocted a system of local income tax. Unlike the Labour party, we argued that case throughout the debates on the Local Government Finance Bill. We gave Ministers details of the alternative system that we would introduce. Ministers did not give figures on or make comparisons with our system, but snatched figures out of the air for their version of a local income tax system to mock it. They


say that they are prepared to consider the Labour party's proposals and produce figures on them, but they dare not do so for a truly accountable and effective system of local income tax.
That is surprising, because every other European country has a system of local income tax, and it is used around the world. No other country uses the poll tax. Local income tax makes more sense. I do not know whether the Minister noticed that I was disturbed by what the hon. Member for Copeland (Dr. Cunningham) said. It appears that the Labour party is moving away from any attempt to introduce in part a local income tax. The hon. Gentleman said that he sought to allocate a proportion of national income tax to local authorities, which is different. We have read in the newspapers that even the leadership of the Labour party believes that the system that it has come up with is too complicated.

Mr. David Blunkett: I should hate another hare to start running, so I shall put the record straight. There has been no change this afternoon. We are in favour of a system based on the capital values of property, adjusted to take account of the income of those in the household.

Mr. Taylor: I may be wrong, but I think we are getting further developments as things go along. It is interesting to listen to what is happening. It would be easiest if the hon. Member for Sheffield. Brightside (Mr. Blunkett) would accept the advice of those in his party who I know believe that a straightforward and simple system of local income tax would be the most workable alternative for the party to defend. I regret that the Labour party was unable to put forward any proposals during our debates on the Local Goverment and Finance Bill. It might have done more to put the Government on the spot at a time when we were all agreed that the existing rating system was an inadequate alternative to the poll tax.
In Cornwall, as in many other areas, domestic ratepayers and business men will be horrified to find that they are being asked to work under and pay for a system which means that the least efficient and the highest-spending authorities are subsidised by those which are most efficient and have the fewest local services. I do not believe that that will be any more popular in my local authorities than many Conservative Back-Bench Members believe that it will be in theirs.
Perhaps I should thank the Secretary of State's predecessor for handing me votes on a plate, but I honestly believe that the impact on those who will have to pay the poll tax—it will hit the poorest hardest—is insupportable. I regret the fact that those people will be penalised in that way. Although he was handed a job that he wanted to take and that will allow him to develop many of his ideas on the environment and other areas, which we look forward to hearing, I believe that the Secretary of State will regret the fact that he has to defend the indefensible and put forward a policy that hits those who are most defenceless.

Mr. John Heddle (Mid-Staffordshire): I join other right hon. and hon. Members in sincerely congratulating my right hon. Friend the Member for Bath (Mr. Patten) on his appointment as Secretary of State, and my hon. Friend the Member for Wirral, West (Mr. Hunt) on his appointment as Minister of State. I would like to place on record my

personal gratitude to my right hon. Friend the Member for Cirencester and Tewksbury (Mr. Ridley) for the consistently courteous and thoughtful way in which he received many of us who are especially interested in matters affecting the Department of Environment and local government. His attitude and his approach to his parliamentary colleagues bore no relationship to the sort of comments that we have heard from Opposition Members and those that have appeared in some of the less informed sections of the media.
I join my right hon. Friend the Member for Brent, North (Sir R. Boyson) in wanting a closer, healthier link between central Government and local government, and between local government and the householder and the consumer of local government services. I ask my right hon. Friend, as a former Minister in the Department of Education and Science, when he further considers the matters generally, to give further thought to the possibility of the transfer of teachers' salaries to the centre, which would inevitably mean a lower community charge bill for all households.
The whole question of the reform of the domestic rating system has moved since 1974 further and further up the political agenda. All major and serious political parties at the last election committed themselves to a reform of the domestic rating system. However, the Conservative party was the only one to come forward with any credible alternative, having given serious and comprehensive thought to all other alternatives. It was for that reason that I supported, in principle, this legislation through all its stages.
However, the official Opposition simply said, "We will abolish the Rates Act and we will do away with the community charge in Scotland." There was no mention in their manifesto of any alternative, but now it has crept out bit by bit—the twin tax of capital valuation and local income tax. I was delighted to hear from the hon. Member for Sheffield, Brightside (Mr. Blunkett) that the official Opposition are still committed to those two unfair strands of taxation. They are committed to them because they represent a wealth tax and have no relationship with the value of a person's property, whether they own it or not, or to the cost of the services provided.
I will give way to the hon. Member for Brightside if he can confirm to me and to all my Mid-Staffordshire constituents, who do not own their own homes, but who are tenants of local authorities, that what they would pay, if a Labour Government were subsequently returned, would be a capital tax based on the value of the property which they occupy, even though they do not own it. [Interruption.] I will willingly give way to the hon. Gentleman. I am grateful for the confirmation that 40 per cent. of local authority tenants in Lichfield and Cannock Chase district councils and Stafford borough council will pay a valuation tax based on the capital value of a property in which they have no personal direct stake.

Mr. Blunkett: In view of the way in which the hon. Gentleman is managing to create himself a scenario, which is completely out of tune with what we are suggesting, I shall put him straight. We are not suggesting that people will be in that position. I made it clear that our tax would be a fair tax and it would therefore take account of the ability to pay of those in the household. That is different


from what the hon. Gentleman has said. It would be over and above the question of rebates, as all progressive taxes should be.

Mr. Heddle: As the hon. Gentleman has responded to my invitation, I shall push him a little further. I ask him yet again to confirm that the capital taxation that his party proposes to introduce will be based on the value of a person's property, even though he does not own it. In other words, a council tenant occupying a property in Mid-Staffordshire, possibly worth £100,000, will pay tax to the local authority, especially if his income is in excess of the threshold which the hon. Gentleman implied would be introduced. Is that true or false?

Mr. Blunkett: The hon. Gentleman must make his own speech, and defend this iniquitous tax.

Mr. Heddle: I am just about to come to that. The hon. Gentleman has confirmed the worst fears of a significant proportion of the population who do not own their properties. We shall pursue that point relentlessly between now and 1992, until the truth is told.

Mr. Dennis Turner: Will the hon. Gentleman give way?

Mr. Heddle: I am sure that the hon. Gentleman will have an opportunity to make his speech. I know that a number of Opposition Members wish to make their contributions. If the hon. Gentleman will allow me, I would like to pursue the policies of the Liberal party. At the last election, in its manifesto, the Liberal party, under the paragraph beginning
Local government needs a fair system of local finance which the rates no longer provide",
said:
We are committed to the planned introduction of a local income tax as the main source"—
not the only source—
of local government revenue in place of domestic rates. We believe that business rates should be related to ability to pay and we will consult with industry and commerce as to how this can be achieved.
The second part of that commitment means that the Liberal party does not have any policy at all on how non-domestic ratepayers should be treated.

Mr. Turner: Will the hon. Gentleman give way?

Mr. Heddle: No, but I shall willingly give way to the hon. Member for Truro (Mr. Taylor) if he will now tell the House and the nation how much he would put on the standard rate of income tax to take account of local income tax to fund the main contribution of local government expenditure, and then what other additional tax he would impose to take account of the balance.

Mr. Matthew Taylor: The hon. Gentleman is more than welcome to have a copy of our pamphlet on this subject. If he drops me a note, I will send him a copy. The answer is that, as the tax will be set locally, it will, of course, vary, but it will vary between 5 and 8 per cent., roughly speaking.

Mr. Heddle: I am baffled by the hon. Gentleman's answer—between 5 and 8 per cent. of what? If it was between 5p and 8p in the pound on the standard rate of income tax, I would believe that the hon. Gentleman was

somewhere near the truth because those were the figures produced by the Layfield committee when it reported in 1977.
That brings me back to the position today. Why was the Conservative party committed to reforming the rating system in the first place? The answer is not only because the domestic rating system is wholly out of date and wholly unfit for the second half of the 20th century and bears no relationship to the cost of the services provided, but because successive Governments—both the Conservative Government in the early 1970s and subsequently the Labour Government and then the Government under the control of the Liberal party in partnership with the Labour party—funked the issue of rating reform. It is because there is now no possibility of revaluing domestic property on any sensible scale that an alternative system had to be introduced.

Mr. Turner: On behalf of the people of Mid-Stafford-shire, will the hon. Gentleman address the issue that we are debating—the here-and-now position of thousands and thousands of people in his constituency and in mine who will have to pay a heavy price for this change of policy? Will the hon. Gentleman tell the people of Mid-Stafford-shire that they will pay precisely the amount that was quoted in the paper produced last week by his right hon. Friend the previous Secretary of State? Is that a correct figure? No, it is a false figure. Will he tell the people of Mid-Staffordshire that they will have to pay more than the Government are saying they will have to pay?

Mr. Heddle: I am grateful to the hon. Gentleman for inviting me to conclude my remarks. We have established that the official policy of the Labour party is that a significant amount of the money that it would raise if it were in government would be found from the tenants of properties and would be based on a capital value in which they have no interest and over which they have no control. We have established that the Liberal party would increase the standard rate of income tax by between 5 and 8 per cent., or thereabouts. In the absence of any more comprehensive information, I believe that figure to be absolutely correct——

Mr. Matthew Taylor: rose——

Mr. Heddle: No, I have given way once to the hon. Gentleman already.
I turn now to the safety net and to the position of my constituents in Mid-Staffordshire and to those of the hon. Member for Coventry, South-East—[Interruption.]

Mr. Nellist: What have I done?

Mr. Heddle: I beg the hon. Gentleman's pardon. I meant the hon. Member for Wolverhampton, South-East (Mr. Turner).

Mr. Nellist: rose——

Mr. Heddle: It is inevitable that in transferring from one——

Mr. Nellist: Will the hon. Gentleman give way?

Mr. Heddle: It is inevitable—[HON. MEMBERS: "Give way."] It is inevitable that anomalies will arise when transferring from an unfair and outdated system. They have arisen in the non-domestic sector and that is why my right hon. Friend the Member for Cirencester and


Tewksbury introduced transitional relief phased over a five-year period. I do not believe that period to be long enough, because it will coincide with the next revaluation in 1995 and, having regard to the fact that most commercial and industrial leases today have rent reviews every five or seven years, it will add to the temporary rates burden on the non-domestic sector. I should like to pursue that matter further with my right hon. Friend the Secretary of State in correspondence.
The transitional relief that my right hon. Friend's predecessor introduced for the non-domestic sector should form the basis for a transitional relief, by way of a safety net, in the domestic sector. I join my right hon. Friend the Member for Brent, North in wishing to see the safety net expanded and funded from central taxation, but targeted most specifically on those in particular need.
My constituents in Mid-Staffordshire are sick to death having to fund the expenditure of spendthrift and profligate local authorities, such as the adjoining local authority of the city of Stoke-on-Trent, when they themselves are well provided for by the prudent and Conservative-controlled Lichfield district council and Stafford borough council.

Mr. Dave Nellist: The bonhomie of Cabinet reshuffles tends to pass me by. I fail to see how a rubber stamp can be reshuffled. The only achievement of the new Secretary of State for the Environment in opening the debate was his acknowledgement that he has been handed a poisoned chalice—one that saw off his predecessor yesterday and one that I confidently predict will see off both him and the Prime Minister before the next general election.
Last week, we had a near-riot when Tory Members finally discovered what the poll tax is about in terms of the safety net. They were rewarded for their political cowardice in voting for it last summer when they suddenly realised that between 25 and 30 marginal Tory seats could be affected at the next general election. Again, I confidently predict that that number will be one third, if not less, of the number of seats that will be lost to the Tory party in Scotland, in England and in Wales by the full enactment of the poll tax legislation—if it goes ahead.
Just under two years ago, the Tory Reform Group described the poll tax as
fair only in the sense that the Black Death was fair; it is indiscriminate. striking at young and old, rich and poor, employed and unemployed alike".
That description was wrong in one basic respect. At least the rich could catch the plague—the rich will not catch the poll tax. That is why, last summer, when an amendment to the legislation was being considered by the other place, 100 Lords were literally dug up to vote it down. Individuals such as Lord Vestey, the owner of Dewhurst butchers, currently pays £6,000 in rates on a country estate, but will pay only £200 in poll tax, while I and other hon. Members, especially Labour Members, have constituents on £50 or £60 per week who will have to spend between 10 and 15 per cent. of their income on the new poll tax.
The poll tax is a wealth transfusion from the poor to the rich. It was introduced in Scotland this April, and one year later—next April—we will get it in England and Wales. Why the difference? Perhaps there are still some military strategists in the higher echelons of the Tory party who remember the basic lesson of not taking on all one's

enemies in one go. The Government decided to divide and rule and to have a testing ground to see how the poll tax goes, because that leaves the possibility of withdrawing it later, if necessary.
What happened in Scotland? On the introduction of the poll tax, The Scotsman described the chaos of the poll tax as like
waking up to a nightmare.
Earlier this month, having contacted all the officials of the regional councils, the Scotland on Sunday newspaper estimated that the level of non-payment of the poll tax was 800,000 people out of the 3·9 million people on whom it is levied. However, I believe that that figure of 800,000 is on the low side, for two reasons. First, the numbers who have paid the poll tax have been artificially inflated by counting somebody who has paid the whole year's poll tax as 12 people. Secondly, the figure of 800,000 does not include those people who have paid the first instalment of the poll tax but have now decided not to make the second or subsequent payments. Those 800,000 people in Scotland have crossed the Rubicon; they have decided on the illegal non-payment of the poll tax.
If one transposes those figures to England and Wales, and assumes that the conditions here next April will be exactly the same, one must assume that more than 7 million people will be unable or unwilling to pay the poll tax. That is a staggering figure. At that level, the poll tax will be unworkable.
Why are so many people refusing to pay the poll tax? Bodies such as the Scottish Federation of Anti-Poll Tax Unions have played a major part in the campaign. There are now 550 anti poll tax unions in England, Scotland and Wales, most grouped into city or regional federations. I address two or three meetings every week about the poll tax, and the attendance is double the attendance I would expect at a meeting on any other subject.

Mr. John Marshall: Twice zero is zero.

Mr. Nellist: The hon. Gentleman makes cracks. but I can tell him that the meetings I address are usually attended by between 100 and 500 people.
The poll tax is one of the most serious attacks on the living standards of working-class people and the provision of jobs and services by local authorities in the 10 years under this Government. In the past four months alone, there have been three demonstrations, two in Glasgow and one in Edinburgh, attended by more than 20,000 people. Those in the Press Gallery should ask their editors why the London-based newspapers have never reported those demonstrations. I checked in the Library on the Monday following those demonstrations and there was not a single report. Are they afraid of contagion, of mass non-payment spreading south of the border? That is the only conclusion I can draw from that.
For 15 years, the Prime Minister has been making vague promises and pledges about the abolition of the rates under her Government. In 15 years in politics, most of the complaints I have received about the rates have been not about the method of collection but, in the past eight or nine years, about the amount people have had to pay. The main reason why rates have more than doubled in the past 10 years has been the £31,000 million in rate support grant withheld from local authorities because of cuts in Government funding.
If people are casting around for simple solutions to the opposition to the rebates, one solution could be to restore


Government funding to 1979 levels. That would mean that Coventry would get back some if not all of the £110 million stolen from us in the past eight years. Domestic rates could be halved merely by restoring the level of Government funding to that pertaining at the beginning of the decade.
Another way in which domestic rates could be halved involves a precedent which the Government have developed and exposed most recently yesterday. According to the Secretary of State last week, if the poll tax were in operation this year, it would be £315 per head in Coventry—the highest figure in the west midlands. The lowest figure in the west midlands would be in Hereford, at £167.
Conservative Members such as the hon. Member for Mid-Staffordshire (Mr. Heddle) would say that the council in Coventry is profligate or spendthrift, but let me tell him and others who believe such idiotic notions that Coventry has not had the money to build a single council house since 1981. It is closing down old people's homes and children's nurseries because of the cuts in Government funding. It is heading towards a crisis in education because of lack of school provision.
One of the reasons for charging £315 per head is that Coventry was bombed out during the second world war, with the destruction of virtually the entire city centre and much of the housing stock, so it has had to build a large number of council houses. Where do local authorities get such funds? They borrow from banks and finance houses. Over the past 40 years, Coventry's debt has risen to £300 million to build houses, schools, roads and community centres and the city council has to pay interest charges on that money. Every year, Coventry pays £30 million in debt service charges, not repayments. If Coventry were not paying that level of interest, it could halve domestic rates again.
However, is cancellation of debts impossible? Not for Rover, when £640 million-worth of debt was cancelled to give the company away to British Aerospace; or Rolls-Royce when £670 million was cancelled for privatisation; or the water authorities, when £5,000 million of debts have been cancelled. Yesterday, in the electricity privatisation statement, £4·4 billion of debt was effectively cancelled by the removal of the Magnox nuclear power stations from that privatisation. If financial restructuring can take place on that scale, I am sure that it will not be beyond a future Labour Administration to tackle the millstones around the necks of local authorities which have had to borrow money to build the infrastructure of cities. If we cancelled local authorities debt and restored the level of Government support, domestic rates would be one quarter what they are today and no one would object about the level of their rates.
The official Government figure for Coventry's poll tax is £315 per head. The city treasurer estimates that it will be £350, and it could be £60 higher, depending on Government grants to Coventry. Last week, we heard that total Government spending on local authorities would rise by about 3·8 per cent. over this year's spending, but inflation is 8·5 per cent. so there will be a 5 per cent. gap in total Government funding to local authorities. If the poll tax is up and running by next April, local authorities

will control only one quarter of their spending and three quarters will be controlled by Whitehall setting the business rate and the level of Government grant.
How will Coventry bridge a 5 per cent. shortfall in Government funding? The only way is through a 20 to 25 per cent. increase in poll tax, which would increase it to £394. But even the £315 figure assumes that everyone will pay the poll tax. But if, as in Scotland, 20 per cent. are unable to pay, and as the poll tax has to raise the total sum for the council from the people who actually pay it, the tax will have to increase by 25 per cent. so that Coventry council can raise the money it needs.
The head of the local government division of the Chartered Institute of Public Finance Accountancy, Rita Hale, wrote in a recent article:
building in 5 per cent. inflation and … unwinding safety nets, there were increases in local bills"—
that is the poll tax—
from one year to the next of 30–40 per cent. When you've got that happening by the mid-1990s, you start to question whether it can be sustained as a believable system.
With the reduction of the safety net, and current inflation, particularly if the Government do not match the needs of local authorities with decent grants, the level of poll tax will double or treble in the next four, five or six years.
I shall not speak for long, as some of my hon. Friends have waited several weeks to get into a debate on the poll tax, as I have. I shall briefly examine who will be worst hit by the poll tax. Eighty per cent. of the young people who are in work earn less than the Council of Europe decency threshold of £150 a week, but they will have to pay exactly the same poll tax as anyone earning more.
About 10 minutes ago, the hon. Member for Birmingham, Northfield (Mr. King) mentioned rebates. Let us examine the rebates for young people. The official Government figure for Coventry's poll tax is £315. Any young person under 25—including any rights to Government funding through family credit or benefit—who takes home more than £61·35 a week will have to pay the full £30 to £40 a month in poll tax. In Birmingham, the estimated figure is £307. Single people under the age of 25 who take home more than £60·55 a week do not have a rebate.
The vast majority of young people escape unemployment by taking cheap labour jobs in hotels, cafes, bars, shops, restaurants, clothing establishments and other places and will lose the minimum protection of wages council rates if the next Employment Bill abolishes those wages councils. How does the hon. Member for Northfield expect those youngsters who are on a maximum of £80 or £90 a week to pay? If they take home more than £60·55 a week, there is no rebate. He should not tell the House of Commons about the rebate system, as it is non-existent.
Last year, 64,000 student nurses were told that they would receive an 80 per cent. rebate. Then, in the guise of a written answer, it was withdrawn. Unless Project 2000 is up and running—and that will take three or four years—there is no rebate for student nurses.
The 80,000 homeless teenagers in Britain will increase in number by those who leave home to avoid paying the poll tax. That is what has happened when youngsters have been forced to pay 20 per cent. of rates becauseof cuts in housing benefits and delays in the payment of that benefit.
What about women? On average, women earn between two thirds and three quarters of the average wage of a


man, but they will have to pay the same poll tax. Five million women in this country cannot go out and take jobs, because they are underpinning the National Health Service or the local authority social services department by being carers who are looking after elderly or infirm relatives, or sick or disabled children. There is no rebate for them under the poll tax if they are not on income support.
What about black and Asian families? I come from a pit village in Yorkshire. When I left home at 18, I did not know that small families existed. I grew up with my mum, my dad, my grandma, my grand-dad, my great-uncle and two sisters. There were eight in our household. As I grew up in the 1960s and 1970s, I realised that people liked to leave their families earlier and move away.
That is not the tradition in West Indian and Asian households. Eleven per cent. of West Indian households and 29 per cent. of Asian households contain six or more adults because they look after their old folk rather than allowing them to go into residential accommodation. In Coventry, they could be living in a presently low-rated property and paying £300 or £400 in rates. They will face bills of £2,500 under the poll tax, so it discriminates against the black and Asian community.
We hear about exemptions. The only way to escape the poll tax is to be declared insane or to join a monastery or the Foreign Legion; and people have been trying that in recent weeks. One of the most disgraceful aspects of the poll tax is that those with a mental handicap, which is a disability from birth, can find some relief from the poll tax if they get the agreement of two doctors, but the level of disability is irrelevant for physical disabilities and there is no rebate or exemption from the poll tax. Some old folk develop Alzheimer's disease, even if it is not assisted by faulty water purification in the south-west. What about old people who become more confused and more infirm as they get older and who develop mental disabilities? They are not exempted from the poll tax.
What about youngsters who stay on at school to do A-levels? They are exempt while they are 18 and their mothers are still getting child benefit for them, but on the day of their 19th birthday, they will lose all exemptions. There are 76,000 families with youngsters who stay on past their 19th birthday to re-take their A-levels.
What about the dead? There are no exemptions for them. [Laughter.] That provokes laughter among Tory Members and I hoped that it would. I want to see them laugh when they hear about two real cases. Donald McLean from Elgin died at the age of 39 on 4 April, three days after he was due to start paying the poll tax in Scotland. His grieving father, whose wife also died recently, was sent a £1·43 poll tax bill for his son. That callous lack of sympathy led his father to complain bitterly:
It's a wonder he wasn't billed for the few hours he lived into the 4th day of April.
Donnie Young, a 43-year old trawlerman from Burghead, was killed at sea on 10 April. He set sail on 26 March and never set foot again on the Scottish mainland. A bill for £6·44 was sent to his widow. Mrs. Young is refusing to pay, and I congratulate her on that. Public pressure forced the Democrat chairman of the Grampian finance committee to back off on the case of Donald McLean and set a limit of £5 below which bills would not be sent out in cases of bereavement, but the Audit Commission has ruled that a poll tax bill has to be sent on

every demand, even if it is as low as 72p. Let us see Tory Members laugh now about sending bills in cases of bereavement.
I give a clear warning to the new Secretary of State that millions of people in England and Wales will not be able to pay and that millions more will be unwilling to pay the poll tax because of the unfairness of the system. A movement of popular resistance is growing throughout the country. I and a number of my colleagues, including my hon. Friend the Member for Dunfermline, West (Mr. Douglas) have said that we will not pay the poll tax. We have been saying that since last July, and we repeat it again today.
That is not a decision we take lightly. We do not come here as law makers to argue universally in favour of law breaking. I do not go out of this Chamber and say that people should run bairns down on zebra crossings. There are certain morally justifiable laws which we all accept should be kept for the good running of society. But the poll tax is not morally justifiable; it is a class law, designed to benefit the rich at the expense of the poor.
Our great-grandparents broke the class laws at the turn of the century and gained the right for workers to join trade unions. Sixty or 70 years ago, in addition to those who threw themselves in front of horses in the Derby, women—and especially the working-class women at the cotton mills in Lancashire and the north-west—broke the class laws of the 19th century to give women the right to vote. The poll tax, which threatens people's democratic right to vote, their living standards, their jobs and their services from local councils, is in precisely the same mould as that class legislation of the 19th century.
I have no compunction about arguing that people should not pay. We shall not be alone. A major campaign is brewing up inside the trade unions. Only last month, the National and Local Government Officers Association at its conference in Blackpool passed a resolution that providing mass non-payment was a viable option and that there was a viable national campaign, the association would back that campaign. I have a message for the Secretary of State and his hon. Friend the Member for Salisbury (Mr. Key), who keeps interrupting him from behind. People in factories and offices throughout the country are discussing the formation of anti-poll tax unions. By the end of the year, the numbers will run into four figures.
I can mention only briefly those who presently pay their rates within their rents. In Scotland, people find that they are paying the same rent and being charged the poll tax, and that is perfectly legal. There is opposition to the poll tax in Coventry. I have received letters from club stewards in working men's clubs, such as that from Mr. Ron Nicholson from Canley, asking whether they too will face the same problems those living in Scotland already face.
I have another question for the Secretary of State—to which I shall return in the next Session—which affects two of his major responsibilities. At present, water rates are based on the rateable value of a house. What will happen when we do not have rateable values because we have the poll tax? I can predict what will happen. Along with privatisation, the water authorities will take the opportunity to hike up the level of the water charges. They will bring in a mirror image of the poll tax, with a water poll tax based on the number of people who live in a house.
What will the effect be on civil liberties? There are dozens of local authorities, such as Solihull, where


personal privacy has been invaded by over-detailed registration forms being sent out. [Interruption.] The Secretary of State should listen for a second. I have read many of the 736 sets of regulations, which we have not debated properly because they are introduced at dead of night, such as on 23 May, when we debated 94 pages in one and a half hours.
What will the Secretary of State do about a person who, at present, can go to the social services department of a local authority and say with confidence that he suspects that a bairn is being sexually or physically abused down the road? A person can give such information in confidence to the social services department knowing that an investigation can take place and he can hope that a tragedy like the case of Jasmine Beckford will be prevented. What will the Secretary of State say when those same officers are told by the community charge registration officer that they have to give up their confidential records and reveal to him the names and addresses of the people who had informed the social services department about potential child sex abuse? That is the depth of the invasion of personal privacy to which the poll tax reaches. I say to the hon. Member for Pembroke (Mr. Bennett): read the regulations, sunshine, to find out whether that is legal or not.
The Chancellor of the Exchequer may escape getting his head chopped off, which was the fate of the Chancellor in the peasants' uprising in 1381, but I predict that the new Secretary of State and his mistress, the Prime Minister, will not escape the political decapitation that awaits them in the poll tax battle. The Prime Minister said that the poll tax was to be the flagship of her third term in office. I shall make one final prediction. The poll tax will go down in the history books not as the flagship, but as the Prime Minister's Titanic—and with a bit of luck, the captain is going down with the ship.

Mr. John Marshall: This debate was billed in advance as a major assault upon the community charge. It seems to be a major assault for which most of the troops have no enthusiasm. Throughout most of the debate, fewer than 12 or 15 Opposition Members have been present. During his speech, the poor Democrat, the hon. Member for Truro (Mr. Taylor), had no support from any of his colleagues.

Mr. Clive Soley: That is cheap.

Mr. Marshall: The hon. Member for Hammersmith (Mr. Soley) may regard it as cheap, but the Opposition's motion, and the fact that his colleagues do not want to support it, says something about their enthusiasm for it.
Debates on local government generate a great deal of humbug and synthetic indignation from the Labour party. As one who served in local government for 17 years, I cannot help but compare the concern expressed by the hon. Member for Copeland (Dr. Cunningham) about the level of community charges with the actions of Labour councillors. The Labour party objects to the fact that, in April of next year, voters in London will ask, "Why is the community charge £290 in Barnet when, in the neighbouring borough of Brent, it is £597, and, in the Labour-controlled borough of Haringey, it is £642?"

Opposition Members know full well that Labour councils combine poor quality service with a very high price to the ratepayer. [HON. MEMBERS: "Rubbish."] Opposition Members may say that it is rubbish. In the London borough of Brent the cost per secondary pupil is £2,142, which is 40 per cent. above the average for outer London boroughs. Every day of the week, 2,000 pupils become refugees from the people's republic of Brent and choose to get their education in the London borough of Barnet. The London borough of Brent charges 40 per cent. more and has such a poor service that pupils go in droves to Barnet and Harrow, and a large number of teachers also leave the borough.

Mr. Douglas: The poll tax will not help that.

Mr. Marshall: Of course the community charge will help that. If the hon. Member for Dunfermline, West (Mr. Douglas) did not make so many sedentary observations, I could point out very simply how the community charge will benefit that. The people in Brent will ask, "Why should we pay twice as much for an inferior service as the people in Barnet?" I will quote one statistic to show how the London borough of Brent is twice as expensive for a poorer service.
I refer to housing management. The London borough of Brent can boast of rent arrears of over £8 million, or 46·9 per cent. of its annual rent roll, compared with 3·7 per cent. in the London borough of Barnet. However, the London borough of Brent's housing management costs are 60 per cent. higher than in all the outer London boroughs. Anyone who believes that the Labour party is at all concerned about the level of the community charge should consult the ratepayers in Haringey who had to pay 61 per cent. more, or the ratepayers in Brent who had to pay 30 per cent. more. If anyone wants confirmation, he can ask the Leader of the Opposition himself. In the London borough of Ealing, he has had to pay 30 per cent. more in rates this year than he did last year.
The Labour party is against low rates. When I was a councillor in Ealing, we could boast that we had the lowest rates in west London. When the Labour party took control in 1986, the first thing it did was remove the sign from the town hall. The Labour party was determined that never again would Ealing have the lowest rates in west London.
The motion refers to increasing Government control. That comes ill from a party which, when in government, sought to legislate grammar schools away and to restrict the sale of council houses. One of the greatest benefits facing local government at present is the introduction of compulsory competitive tendering, a course of action to which the Labour party was always opposed. There is no doubt that compulsory competitive tendering is leading to a reduction of about 15 per cent. to 20 per cent. in the prices charged to the ratepayer.

Mr. Peter L. Pike: Is it not a fact that that is at the expense of the conditions and wages of those who work for councils and those who compete for service contracts? We have seen it in the bus industry and we are now seeing it in local authorities.

Mr. Marshall: As the hon. Member for Burnley (Mr. Pike) should know, a majority of the contracts that have gone out to tender have been won by direct labour organisations who, prior to compulsory competitive tendering, used working practices that were far out of date.

Mr. Nellist: How can the hon. Gentleman work in a place like this and say that?

Mr. Marshall: No views could be more out of date than those of the hon. Member for Coventry, South-East (Mr. Nellist). If he regards the House as out of date, he can leave. There would be loud applause from Conservative Members and many of his own colleagues.
There is no doubt that compulsory competitive tendering gives local authorities the opportunity to provide better value for money and better services at the same time. In my experience of local authority work, whenever a contract went out to tender the ratepayer got a very much better deal, and the community charge payer will, too. In the London borough of Ealing, we were able to save hundreds of thousands of pounds on the school meals service. My son came back after a week and said, "Daddy, why are the meals so much better than they were last term?" I said, "Son, you are learning a basic political truth. When services are provided competitively, they are better than they otherwise would be."
The hon. Member for Copeland was concerned about the average community charge bill facing pensioners in the London borough of Barnet. He did not tell the House that the average rates bill there at the moment is £708 or that, next year, under the community charge, it will be £290, or that, if the misguided safety net could somehow be spirited away, it would be £235. Charges for the vast majority of single pensioners in Barnet, be they in my constituency or in those represented by my right hon. and hon. Friends, will be substantially lower than they are today.
It is all very well for the hon. Member for Coventry, South-East to talk about groups such as the disabled. He knows very well that all those groups are currently paying domestic rates. If the Labour party thinks that they should not pay the community charge, why did it not legislate to prevent them paying domestic rates?
The most irresponsible speech that we have heard today was by the hon. Member for Coventry, South-East, who talked about morally justifiable laws. To quote the hon. Member for Dunfermline, West, it is nonsense. It is a recipe for anarchy.

Mr. Douglas: Will the hon. Gentleman give way?

Mr. Marshall: No, I will not give way. The hon. Member for Dunfermline, West makes sedentary interventions which become tedious in the extreme. To give way to him would be to invite a lengthy speech with, no doubt, little relevance to the subject under discussion. He and the hon. Member for Coventry, South-East are seeking to incite——

Mr. Alex Salmond: Will the hon. Gentleman give way?

Mr. Marshall: No, not even to a fellow graduate of St. Andrews will I give way.
The hon. Members for Coventry, South-East and for Dunfermline, West and their boroughs are producing a recipe for anarchy. They are seeking to put forward a course of action that can only interfere with local authorities' cash flows and mean a decline in the quality of services provided next year.

Mr. Nellist: Will the hon. Gentleman give way?

Mr. Marshall: The hon. Gentleman spoke at great length. Throughout his speech he said that there was bale time, but he proceeded to speak at great length.

Mr. Nellist: rose——

Mr. Deputy Speaker (Sir Paul Dean): Order. The hon. Member for Hendon, South (Mr. Marshall) has said that he will not give way.

Mr. Marshall: I now refer to the remarks of my right hon. Friend the Member for Brent, North (Sir R. Boyson).

Mr. Salmond: Will the hon. Gentleman give way?

Mr. Marshall: As the hon. Gentleman is from St. Andrews, his intervention may be valuable.

Mr. Salmond: If I am not mistaken, the hon. Gentleman is a campaigner on behalf of refuseniks in the Soviet Union who are fighting against unjust laws. At the last election, when the poll tax was clearly declared as an election issue, the people of Scotland voted overwhelmingly against it. People in Scotland are fighting against unjust laws. Will the hon. Gentleman summon up some sympathy for the refuseniks in Scotland?

Mr. Marshall: When I visit Scotland this coming weekend, I shall compare it with the Soviet Union, which I visited last year. I suspect that the comparison will be very much to Scotland's advantage. It is absurd to relate the condition of the people of Scotland to the plight of the refuseniks in the Soviet Union. The people of Scotland are part of a unitary United Kingdom. They made England suffer Socialist Governments in 1964 and 1974. They should not be surprised that the Conservative Government of 1987 adhere to the policies on which they were elected.
I want to continue my remarks about the safety net, because people in the borough of Barnet feel as strongly about it as those represented by my right hon. Friend the Member for Brent, North. Under the safety net provisions for next year, the London borough of Lewisham—which the Department accepts is a heavily overspending authority—will receive a safety net provision of £293 and pay a community charge of £215. The London borough of Lambeth, which has long been recognised as one of the most profligate local authorities, will receive a safety-net provision of £246 and will pay a community charge of £297. That will be only £7 higher than that paid in the London borough of Barnet. Why should the ratepayers of Barnet pay £55 in safety-net provision towards the extravagant, high-spending authority of Lambeth?

Mr. John Fraser: Perhaps, as a very late act of conversion, the former Secretary of State recognised the enormous problems in Lambeth. He might have thought that, as a substitute for the old equalisation scheme, it would be a good idea to transfer money from the richer boroughs to the poorer boroughs. That is what happened for many years under the old equalisation scheme.

Mr. Marshall: I agree that Lambeth is in enormous difficulty, but that is mainly because its borough council has done much to aggravate the problems.
The safety-net provision is a tax on low-spending authorities. It is a penalty for prudence and a premium for extravagance. I hope that my right hon. Friend the: Secretary of State will reconsider the safety-net provision and, when he comes to the House in the autumn, tell us that it has been substantially refined.

Mr. Jeff Rooker: I join in the congratulations expressed by hon. Members to the new Secretary of State. As his former responsibilities concerned overseas development and Northern Ireland, our paths have not crossed very often. He will get away with his faux pas at the Dispatch Box today simply because of the regard in which he is held on both sides of the House—and I say that quite sincerely. The right hon. Gentleman has made many trips abroad and his experience is rather more global than mine. I was surprised that he did not bring to the Dispatch Box examples of other countries that operate a flat-rate poll tax system to fund local government.
Some of the sentences in the right hon. Gentleman's brief struck a chord with me. I had already heard them in Committee and on Report more than a year ago. I caution him to look behind the jargon to ensure that he is not fed a duff line. I have no doubt that he will come to understand the differences between tax units, households and individuals. There will always be arguments about the number of single pensioners who might gain from the poll tax, but the right hon. Gentleman should recognise the difference between a single pensioner and a single-pensioner household. The fact is that 1 million single pensioners will lose because not all single pensioners live in single-pensioner households. Such crucial distinctions in the terminology used about the poll tax can sometimes be used to feed new Ministers a bad brief.
In the short time available I shall concentrate, rather more positively than did the hon. Member for Truro (Mr. Taylor), on the effect of the poll tax on living standards. That is where the essential unfairness of the system arises. The poll tax cannot be separated from the changes in social security legislation, especially the compulsory 20 per cent. payment that was introduced in 1986, before the election, but did not come into effect until 1988, after the election. The analysis of how that is provided for in income support shows that it is a crucial factor. There is no doubt that some people will lose and some will gain because of the so-called average amount of 20 per cent. By definition, no one could be poorer than those on income support. Some of them will be worse off, because their income support will not take account of the 20 per cent. of poll tax that they will have to pay.
Any simple system is unfair. That is why life is so complicated in a country of 55 million people. If everyone received the same pay, paid the same amount of income tax and had the same outgoings, the system would not be so unfair. It would be a simple head tax. However, the income and outgoings of families are not the same, so the poll tax will unfairly affect household incomes and family budgets.
The Government argue that the cost of local services should not be hidden by allowing those on low incomes to pay a lower tax. There is a paradox—they want people to pay as high a tax as possible, but it is hidden in the rhetoric of rebates. However, the argument changes slightly when it comes to the safety net, which will severely affect those who will not receive rebates.
I want to give only one brief example from the tome that I collected from the Vote Office yesterday. An average poll tax couple with two children, claiming family credit and housing benefit and with a gross income of £100 a week, will receive a rebate of £2·62 a week. However, the interaction of income tax, national insurance, lost benefit

and the poll tax rebate means that they will have to pay a marginal tax rate of 83p in the pound for every extra pound that they earn over £100 a week. Should that family have a gross income of only £80 a week, their marginal tax rate would rise to 94p in the pound.
Yesterday the Child Poverty Action Group produced a useful publication setting out certain calculations. They have not yet been challenged, but I do not doubt that Ministers will be put up to challenge them, if not tonight then during the recess. However we look at the figures on the poll tax, nothing can hide the fact that only the rich will gain. The poor will lose significantly and the middle-income groups will lose most of all.
Two examples are clearly shown in the publication. The first table gives a simple comparison between poll tax and rates, and ignores all the changes to social security benefits in 1986 and 1988. Only the top three deciles show a gain—the top decile gains £3·65 a week—and the other seven deciles show losses. The greatest loss is in the fifth decile—the middle range. Three quarters of all the families in the bottom 10 per cent. end up worse off. Fifty-six per cent. of families lose and 44 per cent. gain.
That is the position before we take into account the effect of the social security changes. Table 6.2 shows that 63 per cent.—not 56 per cent.—of families lose, and 83 per cent.—not 79 per cent.—of the bottom decile lose more than £1 a week on average. Again, the biggest single losers are the fifth decile, the middle-income groups, with an average loss of £1·72 a week. Only the top 10 per cent. gain. Those figures are produced using average poll tax figures which smooth out many of the unfairnesses. A high poll tax will be paid in deprived areas where income tends to be low. Everyone accepts that that is the case.
I make no apology for taking my constituency as an example. We were told last week that the poll tax for Birmingham will be £307, fully safety-netted. This year, Birmingham is one of five authorities with zero underspend and zero overspend. Were it not for the safety net, the poll tax in Birmingham would be £240 this year. As it is, it will be £307—a poll tax surcharge for the safety net of £67. I do not deny that it will be different in later years, but it is the first year that my constituents will be worried about next April.
There are 35,000 front doors in my constituency. Most hon. Members know the number of letterboxes in their constituencies. I have taken 50 roads, with 7,000 dwellings and 14,000 adults. They comprise one fifth of my constituency—the biggest in Birmingham. This year, those 7,000 dwellings will pay £3·3 million in rates. I have not taken rebates into account because I would not dream of asking for such personal information. Using national averages for empty dwellings and a figure of £307 for each adult's poll tax, the poll tax for the equivalent period would be £4·.3 million—£1 million extra from one fifth of my constituency.
A few of the 50 roads that I chose will be gainer roads. I challenge anyone to say that I have not used a representative group of roads. My constituency will pay an additional £5 million in poll tax. The dislocation that that will cause to the local economy and to families in my constituency does not bear thinking about. The reality is not people refusing to pay; rather it is of paying the poll tax or buying food.
I have four wards in my constituency. Wards in Birmingham are all large, with electorates of between 18,000 and 21,000. In Tintern road in the Handsworth


ward, which is fairly typical and being done up under the urban development scheme, the rates this year will be £33,535. The poll tax will be £70,600—almost double. In Leonard road the rates will be £64,600; the poll tax will be £125,000. The dwellings there are pre-first world war with a less than average rateable value, occupied by average families. However, in the Handsworth ward I am one of an ethnic minority. Some of those dwellings house extended families with six or seven adults and there is no way in which they will be able to pay such sums. In Freer road the rates will be £58,000 and the poll tax will be £111,000.
In the outer-city ward of Kingstanding in my constituency, with 12,000 dwellings built in the 1920s and the 1930s having rateable values within £5 of each other, every couple household will lose because of the nature of the rateable values. In Hurlingham road, the rates will be £69,000 and the poll tax will be £106,000. In Dovedale road, the rates will be £113,000 and the poll tax will be £174,000.
Perry Barr, an outer-city ward from which my constituency takes its name, is a middle-income ward. It is usually the only ward in Birmingham, along with the three wards in Sutton Coldfield, with a below average unemployment rate. Therefore, compared with the others, it is a middle income ward. In Rocky lane, where 800 people live in outer suburban semis—an awful lot of Tory voters—the rates will be £189,000 and the poll tax will be £245,000. In Mildenhall road, which is similar, the rates will he £113,000 and the poll tax will be £151,000.
The Labour party does not get the majority of the votes in those roads. It has come close to winning that ward, but it has not done so since 1963. That is middle-income territory in outer suburban Birmingham. I do not deny that there will be gainers and losers in those roads. In three of my wards, single people will gain, but those living in single dwellings, pre-first world war, in the Handsworth ward, will lose because their rates are less than they will pay in poll tax. That is the reality in low rateable value, deprived, inner-city areas. That is why there will be trouble next year.
No Conservative Member can explain how making a person pay more in poll tax than he pays in rates will put an extra burden of accountability on the city council. Why a constituency such as mine will pay £5 million more in poll tax than in rates cannot be explained away. When one examines the income distribution of other parts of Birmingham such as Edgbaston and Sutton Coldfield, that cannot be defended.
The poll tax is unfair. It is designed to be unfair. That realisation has not come in a blinding flash to me and my hon. Friends. It does not matter how one tinkers with the rebates or what the new chairman of the Tory party will say. There is no way in which, with the best will in the world, pushing back all his previous doubts, trying to present the package in another way and winning a few more million pounds from the Treasury, the Secretary of State and the new Minister for Local Government will ever be able to sell the poll tax. It is too hot to handle and they will soon realise that. The tax's inherent unfairness means that it cannot be sold to the electorate. The Government may face most pressure from Conservative Members in respect of the safety net, but when the bills start dropping through the letter boxes in marginal Conservative constituencies next year, the message will come home.
The Labour party did not want the poll tax and saw no benefit in its inherent unpopularity. We did not say to the Tories, "Please bring in the poll tax because we know that it will make you even more unpopular." Instead, we took every opportunity in Committee and on Report to alter the flat-rate nature of the tax. We also warned the Government that if they persisted, we would screw every ounce of political capital out of their policy at the hustings and at the ballot box. We shall do so, and we do not apologise for that.
Nor do we need to be defensive about out replacement for the poll tax. Any tax, be it based on the occupancy of a property or on the occupant's income, that is directly related to the occupant's ability to pay will always win the argument over a flat-rate tax. That is why the poll tax will not stand the test of time, a change of Government, or even a change of Prime Minister.

Mr. W. Benyon: I warmly welcome my right hon. Friend the Secretary of State on taking up his new appointment. He comes to it with a fresh mind, and his concluding remarks showed his appreciation of the great difficulties that confront him on the community charge.
I have always opposed the community charge and voted against it on every possible occasion. I do not intend to change my record tonight. I shall not rehearse the arguments against the poll tax, because right hon. and hon. Members have heard them over and over, and again this afternoon. Nevertheless, I emphasise to one or two Opposition Members that the tax is now the law of the land and that that law must be obeyed. Conservative Members have a particular duty to make the best of it, because to do so is extremely important in electoral terms.
Whatever method one uses to raise local government finance—be it rates, a community charge, local income tax, or the combination proposed by the Labour party—if the burden on local authorities is too high, people will resist the tax and blame not the local authorities but the Government. I sometimes wonder about the nature of the constituencies that some of my right hon. and hon. Friends represent. Not one of my constituents has said to me, "I am worried that my local authority will be extravagant." Instead, constituents have asked, "Will the local authority be given enough Government grant?"
Reading the Layfield report after so many years repays itself, because the situation is exactly as Layfield described it all that time ago. I say to the Government that they are being blamed now, and if things continue as they are, they will be blamed even more at the next general election. The Treasury's restrictions on any further relief on the tax will be bought at a very high price.
The solution is twofold. First, as has been mentioned by a number of my right hon. and hon. Friends, one must rid the community charge payer of the safety net, which must be borne instead by the Exchequer. I made the point to my right hon. Friend's predecessor last Monday that if there is to be accountability, which is the real reason for the tax, the community charge must get off on the right foot, so that the taxpayer can say, "I know that the community charge being imposed by my local authority is just that and not something different."
Secondly, either the revenue support grant must be increased or a major item of local authorty spending must


be transferred to the Exchequer. If that is not done, the community charge will start life in the worst possible way. The hon. Member for Birmingham, Perry Barr (Mr. Rooker) gave detailed examples of certain wards in his constituency, and they are repeated throughout the country.
If it is found after the community charge is introduced next year that concessions are necessary, they will have to be wrung out of the Government and will be confessions of failure, rather than tokens of success. I urge those of my right hon. and hon. Friends who have joined the Treasury Bench to act now, while there is still time.

Mr. George Howarth: I congratulate the Secretary of State on his new appointment. He must realise from listening to his own hon. Friends on the Conservative Back Benches that the task ahead of him is not to be envied. The poll tax was bad enough in its conception, but its presentation last week by the right hon. Gentleman's predecessor was absolute chaos. The comments of all Conservative Members today, and particularly the eloquent remarks of the right hon. Member for Brent, North (Sir R. Boyson), must leave the Secretary of State in no doubt about the problems confronting him.
The former Secretary of State for the Environment tried to improve the poll tax by softening the blow in Tory constituencies through his use of the safety net. However, this afternoon, speaker after speaker from the Conservative Benches has complained about its effect on his own constituency. My constituency is, by any measure, one of the most deprived in the whole country, yet as a result of the safety net, each payer of the poll tax will have to find £311, for which there can be no justification.
That inequality is not confined to my own constituency. The hon. Member for Wirral, West (Mr. Hunt), who has been elevated to Minister of State, Department of the Environment, may be aware that, as a consequence of the incompetence of the former Secretary of State for the Environment, the Wirral—which is represented also by the right hon. Member for Wallasey (Mrs. Chalker) and the hon. Member for Wirral, South (Mr. Porter)—is the highest-rated on Merseyside, yet still it will contribute to the safety net. I speak up for those right hon. and hon. Members because they are not present in the Chamber to speak for themselves. The hon. Member for Crosby (Mr. Thornton) is in the same position.
Although Merseyside is, justifiably, barely represented by Conservative Members, the Government will penalise not only Labour-held constituencies such as my own but Tory-held constituencies in my area. The malice was bad enough, but the incompetence and chaos that followed penalises even Conservative constituencies.
The poll tax is a bad measure, made worse by the former Secretary of State for the Environment—and I do not think that the mess can be cleared up, even by his successor.

Mr. David Blunkett: I add my congratulations to the Secretary of State and to the hon. Member for Wirral, West (Mr. Hunt) on their promotions.

I shall miss the former Minister for Local Government, the right hon. Member for Suffolk, Coastal (Mr. Gummer)—not because of his personality but because the Chamber will be free of the growling, barking and snarling that so upset my dog very time that the right hon. Gentleman rose to speak. Having now savaged the General Synod, the right hon. Member for Coastal has moved on to do something miraculous with loaves and fishes.
We are talking not about personalities or presentation, but about policies. This afternoon, the Secretary of State commented that the man has changed but the Government's policies have not. That sums up the dilemma facing the Secretary of State and the Government. I do not accept that the right hon. Gentleman believes in the Government's policy or in the words in the brief that he read this afternoon. If he does, he is a lesser man for it. Anyone who has a feel for progressive, reasonable and caring policies knows that the poll tax is not the solution to the problem of an alternative for the present rating system.
The poll tax is based on particular values and ideology that the former Secretary of State for the Environment was more than happy to articulate because he believes in inequality—and said so. He believes in reducing progressive taxation, and was honest enought to say so. It is difficult for someone who does not believe that to put forward a convincing case for a tax that involves equality and uniformity of contribution, but inequality in relation to the amount of misery that it produces. For that is what the poll tax is about: the poor will be hit hardest and the rich will gain most, not only in cash terms—although that is important—but in terms of services.
The Cheshire study carried out not long ago showed clearly that the better-off gained most from the way in which local spending was organised. That applied to education, road use and even the relative cost of emptying dustbins outside large houses with long drives in sparsely populated areas. They will not be charged extra for their services; they will be charged less. They will not feel the burden: it will be borne by the less well-off, the ragged-trousered philanthropists of the 1990s, who will contribute their income so that others may pay less for more advantageous services.
That burden, in terms of payment, is grossly distorted. the railway porter earning just over £100 a week could, in London, be paying 10 per cent. of his income in poll tax, while a Cabinet Minister will be paying 1 per cent. The ratio is 10 to one: that is how much worse off those in work but on low incomes will be than the better-off. That is the stark reality. There is no element of equality, or of payment for services received. It is the opposite: the less people receive, the greater the likely burden on their incomes.
That is why many of those who will gain believe that the poll tax is not only politically inept but morally bankrupt. Millions who will, at least temporarily, be better off will say, like us, that a system that takes from the poor rather than the better-off and distributes resources to the disadvantage of those who are struggling to escape from the poverty trap—as described by my hon. Friend the Member for Birmingham, Perry Barr (Mr. Rooker)—is immoral, and must be rejected on those grounds.
We must recognise that this is not a charge for services rendered, but an unfair and grossly distorted form of taxation. Otherwise, the myth will be put about that we are merely making people pay for the first time. Some


interesting points have been made about that this afternoon. The hon. Member for Mid-Staffordshire (Mr. Heddle) suggested—becoming caught in a tremendously tangled web as he did so—that council tenants would somehow be disadvantaged by an alternative to the poll tax. As his right hon. Friend the Member for Henley (Mr. Heseltine) knows very well and has pointed out, those whose properties have low rateable values will be hardest hit.
Owner-occupiers living in small terraced properties—the category that the right hon. Gentleman described in the Report and Third Reading debates on 18 April last year—may have thought of voting Tory in the past. Let us make no mistake, however: they will not think of doing so in the future, and that applies equally to the people to whom the hon. Member for Mid-Staffordshire referred. We are talking not merely about the impact of the tax on each individual, but about the change in the distribution system that the Secretary of State described. The study carried out by the Child Poverty Action Group and the Local Government Information Unit has shown that, in the 50 most disadvantaged areas in the country, the average loss to the individual will be £58 a year.
The Parliamentary Under-Secretary of State gave me some staggering figures on 25 November last year relating to the losses in the regions. The northern region would lose £156 million, the Yorkshire and Humberside region £256 million and the north-west £91 million. The Secretary of State described the abolition of the equalisation system as a great bonus for the country as a whole. Under that system, inner London loses £493 million. The south-east gains by £525 million, but that can hardly be described as the righting of a great wrong. Clearly the Government have not stepped in like a knight in shining armour to correct a distortion. The effect of what they are doing will be felt throughout the country.
The right hon. Member for Brent, North (Sir R. Boyson) is rightly concerned about the impact of the safety-net provisions. I wondered whether the previous Secretary of State did not have a few tricks up his sleeve a la Lady Porter: if we examine the figures closely, some interesting political conclusions can be drawn. Is it not in the Government's interest for certain London boroughs to find that next year's tax is very high? Is it not in their interest that residents of the borough of Ealing, which they have been attacking, must pay an extra £21 each because of the safety net? In Brent, referred to by the right hon. Member for Brent, North, the figure is £36, and in Haringey it is £15. Is it not advantageous for them to award the borough that I live in, Wandsworth—the jewel in their crown, as they have described it, and the borough that the Conservatives are hanging on to—an incredible safety-net benefit amounting to a staggering £227, reducing my poll tax to £148? Bradford, the other jewel in their crown, will benefit by £36.
The chickens will come home to roost, but presumably, once next year's London and metropolitan borough elections are over, the system will be readjusted to take account of the approaching general election. The Secretary of State would be well advised to put his mind not only to the survival of his Back Benchers in the election—those representing marginal seats containing properties with low rateable values—but to whether the electorate as a whole will begin to suss out what is going on, and what their reaction will be.
I was pleased when the Secretary of State said that he would look again at registration after the shambles that we have already seen, but it is now far too late: people have filled up their forms, believing that they would be behaving illegally if they did not answer questions that have now been ruled intrusive and unnecessary. Any action would be welcome, however. It would also be helpful if the Secretary of State re-estimated the true poll tax average: the Government's 1987 estimate of £178 had risen to £275 in their latest estimate, produced last week. Even then they performed a conjuring trick, assuming that local authorities would be able to contribute the same amount from their balances as last year. Last year, the Government estimated the average poll tax at £274, so Lord knows what the figure will be when they finally get round to being honest about it.
We need an alternative to the poll tax, based on fairness and ability to pay. I give an absolute pledge from the Dispatch Box that our proposals will benefit not only the very poor but those on average incomes above the poverty line, who will pay according to their ability to find the cash. They will not be penalised through capital-value rating; they will not be discriminated against in areas with high property values. This party will treat them decently.
We believe in a system which is fair for the individual and equal in its distribution of the burden throughout the community, and which makes it possible to raise and spend money fairly and equally on decent public services. Our policy will be pitted against the Government's and although the cost of the poll tax must be borne by the people, its price will be paid by the Government in defeat at the polls.

The Minister for Local Government (Mr. David Hunt): Unaccustomed as I have been for two years to speaking from the Dispatch Box, I welcome the opportunity to do so in a debate on a rating system that I have long believed to be discredited and unworkable. I welcome the community charge system, to which I was committed at the last election and to which I remain committed as a much fairer and better system.
I much appreciate the generous words of welcome from hon. Members to my right hon. Friend the Secretary of State and me. I much welcome the warm tributes that were paid to my right hon. Friends the Members for Cirencester and Tewkesbury (Mr. Ridley) and for Suffolk, Coastal (Mr. Gummer)—[HON. MEMBERS: "What tributes?"]. The small group of Labour Members present would be much wiser men if they had listened more carefully to the debate, because they would have heard such tributes.

Mr. Alex Salmond: Will the Minister use his previous experience in the Whips Office to tell the House whom of his hon. Friends will give him the most trouble? Will it be the hon. Member for Milton Keynes (Mr. Benyon), who, in ignorance, voted for the Scottish poll tax, rebelled against the poll tax in England and now wants us to make the best of it? Will it be other Conservative Members who, in ignorance, voted for the poll tax in England and Scotland but are now whining about its impact on their constituencies?

Mr. Hunt: Having had the privilege of being Government Deputy Chief Whip for two years, I do not recognise the meaning of the word "trouble" with my right


hon. and hon. Friends. From time to time, we may have genuine disagreements, but we are united, especially about the unfairness of the present rating system and the importance of the new one. Concern was rightly expressed about how the community charge should be introduced.
I heard 12 speeches from start to finish. Although I disagree with many of the points made by Labour Members, I congratulate all hon. Members who participated in a good debate. Having sat for some time on the Select Committee considering the televising of Parliament, I think that a debate such as today's will do the House much credit when it is televised in the autumn.
Labour Members have not spoken to their motion, nor have they proved a word of it. It says that the community charge is unfair, bureaucratic and difficult to collect. Those allegations would be serious had Labour Members substantiated them, but they have not. Labour Members have been unable to prove their case. Thanks to some clever speeches from Conservative Members, Labour Members have been forced on to the defensive—[Interruption.] Those who are shouting loudest have been most noticeable by their absence from the debate. Labour Members have been forced on to the defensive because they have been unable to defend an alternative policy that changes every day. The Labour party has been unable to control Labour Members who advocate illegal action; we heard two speeches of that nature from Labour Members this afternoon.
Perhaps the most serious allegation made against the new arrangements is that of unfairness. The only way that Labour Members can begin to substantiate that charge is by deliberately not taking into account the generous rebate system that we have built into the new arrangements. I have much time and respect for the hon. Member for Birmingham, Perry Barr (Mr. Rooker). I remember that he celebrated my appointment as Whip on the Finance Bill by leading for the Opposition on that Bill, which lasted longer than any previous Finance Bill. I came to know the hon. Gentleman reasonably well, and I believe him to be a fair man. Being a fair man, he will recognise that those little words at the end of his press release which say that he left out of his calculations rate rebates or community charge rebates in reaching his conclusions, throw his calculations into disrepute.

Mr. Rooker: The only way that one can compare like with like is to use unrebated figures. It is not possible for any hon. Member to ask a local authority, "What are the rates for a road net of rebate?" That is private information. I argued that the same would apply if one compared rebated figures, but that information is not available because it is confidential. When it is, I shall do the same exercise.

Mr. Hunt: The hon. Gentleman has shot his own fox. He said that, when comparing the effect of rebates, he failed to take into account the fact that the rebate system that we are proposing is far more generous than the present one, and he knows that.

Dr. Cunningham: rose——

Mr. Hunt: Let me deal with the hon. Member for Perry Barr.
The hon. Member for Perry Barr said that the community charge is unfair, but I contend that it is much fairer than the domestic rating system. When the community charge is fully implemented, 58 per cent. of households—over 11 million adults—will gain; 83 per cent. of single-pension households will pay less in community charge than they pay in rates; and 75 per cent. of other single-adult households—widows and one-parent families—will gain. On average, the community charge will cost less than domestic rates for all income bands below £200 a week.

Dr. Cunningham: How can it be fairer to make people who pay nothing because their earnings are low pay a minimum of at least 20 per cent. of the charge?

Mr. Hunt: The hon. Gentleman ignores income support. When considering the overall impact of the community charge, we must not pick and choose. Labour Members already have the relevant information.
My right hon. Friend the Member for Brent, North (Sir R. Boyson), who made a typically robust defence of the community charge, said that people must pay something for the local services they use, but that the community charge must not be artificially high. A number of hon. Members mentioned the safety net. We shall consider carefully what they said, but I emphasise that the purpose of the safety net is to phase in the new system over a relatively short period, so that those who lose have an opportunity to adjust to the new circumstances. Gainers will receive a substantial part of their gain in the first year, but they cannot receive all their gain if areas facing sharp increases are to be given time to adjust.
My right hon. Friend the Member for Brent, North suggested that the taxpayer—the Exchequer—should pay for the safety net. The proposals announced last week for next year's grant settlement envisage an 8·5 per cent. increase in the amount to be provided from Government grants and business rates. I believe that to be a fair and reasonable increase in Exchequer support. But we shall listen and consider: this is a matter of balance and it cannot be solved by throwing money at it.

Mr. Nellist: I have a question in two parts for the Minister. The first is about rebates. Is he aware that in Coventry, for example, where the poll tax will be £315, according to official Government figures, a single person aged under 25 will receive no rebate if he or she takes home more than £61 a week? Secondly, since when has the business rate been part of Exchequer contributions to local authority spending?

Mr. Hunt: Again, the hon. Gentleman has totally missed the point—[Interruption.] Far more serious was the speech he made earlier in the debate, in which he advocated support for illegality. How can the hon. Member for Sheffield, Brightside (Mr. Blunkett) expect one day to become a Minister of the Crown without condemning the intemperate words used by his hon. Friend the Member for Coventry, South East (Mr. Nellist)?
The policy of the Opposition changes day by day. When they have a policy, let them come to the House and seek support for it. I urge my right hon. and hon. Friends to reject the motion and support the amendment.

Question put, That the original words stand part of the Question:—

The House divided: Ayes 211, Noes 304"

Division No. 320]
[7.1 pm


AYES


Abbott, Ms Diane
Fraser, John


Adams, Allen (Paisley N)
Galbraith, Sam


Allen, Graham
Galloway, George


Alton, David
Garrett, John (Norwich South)


Anderson, Donald
Garrett, Ted (Wallsend)


Archer, Rt Hon Peter
George, Bruce


Armstrong, Hilary
Gilbert, Rt Hon Dr John


Ashdown, Rt Hon Paddy
Godman, Dr Norman A.


Ashley, Rt Hon Jack
Golding, Mrs Llin


Ashton, Joe
Gould, Bryan


Banks, Tony (Newham NW)
Graham, Thomas


Barnes, Harry (Derbyshire NE)
Grant, Bernie (Tottenham)


Barnes, Mrs Rosie (Greenwich)
Griffiths, Nigel (Edinburgh S)


Barron, Kevin
Griffiths, Win (Bridgend)


Battle, John
Grocott, Bruce


Beckett, Margaret
Hardy, Peter


Bell, Stuart
Harman, Ms Harriet


Benn, Rt Hon Tony
Hattersley, Rt Hon Roy


Bennett, A. F. (D'nt'n &amp; R'dish)
Haynes, Frank


Bermingham, Gerald
Healey, Rt Hon Denis


Bidwell, Sydney
Heffer, Eric S.


Blair, Tony
Henderson, Doug


Blunkett, David
Hinchliffe, David


Boyes, Roland
Hoey, Ms Kate (Vauxhall)


Bradley, Keith
Home Robertson, John


Bray, Dr Jeremy
Hood, Jimmy


Brown, Nicholas (Newcastle E)
Howarth, George (Knowsley N)


Buckley, George J.
Howell, Rt Hon D. (S'heath)


Caborn, Richard
Hoyle, Doug


Callaghan, Jim
Hughes, John (Coventry NE)


Campbell, Menzies (Fife NE)
Hughes, Robert (Aberdeen N)


Campbell, Ron (Blyth Valley)
Hughes, Simon (Southwark)


Campbell-Savours, D. N.
Illsley, Eric


Canavan, Dennis
Ingram, Adam


Cartwright, John
Janner, Greville


Clark, Dr David (S Shields)
Johnston, Sir Russell


Clarke, Tom (Monklands W)
Jones, Barry (Alyn &amp; Deeside)


Clay, Bob
Kennedy, Charles


Clelland, David
Kilfedder, James


Clwyd, Mrs Ann
Kinnock, Rt Hon Neil


Cohen, Harry
Kirkwood, Archy


Coleman, Donald
Leadbitter, Ted


Cook, Frank (Stockton N)
Leighton, Ron


Cook, Robin (Livingston)
Litherland, Robert


Corbett, Robin
Lloyd, Tony (Stretford)


Corbyn, Jeremy
Lofthouse, Geoffrey


Cousins, Jim
Loyden, Eddie


Crowther, Stan
McAllion, John


Cryer, Bob
McAvoy, Thomas


Cummings, John
McCartney, Ian


Cunliffe, Lawrence
Macdonald, Calum A.


Cunningham, Dr John
McKay, Allen (Barnsley West)


Darling, Alistair
McKelvey, William


Davies, Rt Hon Denzil (Llanelli)
McLeish, Henry


Davies, Ron (Caerphilly)
Maclennan, Robert


Davis, Terry (B'ham Hodge H'I)
McNamara, Kevin


Dewar, Donald
McWilliam, John


Dobson, Frank
Madden, Max


Doran, Frank
Mahon, Mrs Alice


Douglas, Dick
Marshall, Jim (Leicester S)


Duffy, A. E. P.
Martin, Michael J. (Springburn)


Dunnachie, Jimmy
Martlew, Eric


Dunwoody, Hon Mrs Gwyneth
Meacher, Michael


Eadie, Alexander
Meale, Alan


Evans, John (St Helens N)
Michael, Alun


Ewing, Harry (Falkirk E)
Michie, Bill (Sheffield Heeley)


Ewing, Mrs Margaret (Moray)
Morgan, Rhodri


Fatchett, Derek
Morley, Elliot


Fearn, Ronald
Morris, Rt Hon A. (W'shawe)


Field, Frank (Birkenhead)
Morris, Rt Hon J. (Aberavon)


Fields, Terry (L'pool B G'n)
Mowlam, Marjorie


Fisher, Mark
Mullin, Chris


Flannery, Martin
Murphy, Paul


Flynn, Paul
Nellist, Dave


Foot, Rt Hon Michael
Oakes, Rt Hon Gordon


Foster, Derek
O'Brien, William





Orme, Rt Hon Stanley
Soley, Clive


Owen, Rt Hon Dr David
Spearing, Nigel


Patchett, Terry
Steel, Rt Hon David


Pendry, Tom
Steinberg, Gerry


Pike, Peter L.
Stott, Roger


Powell, Ray (Ogmore)
Straw, Jack


Prescott, John
Taylor, Mrs Ann (Dewsbury)


Primarolo, Dawn
Taylor, Matthew (Truro)


Quin, Ms Joyce
Thompson, Jack (Wansbeck)


Radice, Giles
Turner, Dennis


Randall, Stuart
Vaz, Keith


Redmond, Martin
Wall, Pat


Rees, Rt Hon Merlyn
Wallace, James


Richardson, Jo
Walley, Joan


Roberts, Allan (Bootle)
Wardell, Gareth (Gower)


Robinson, Geoffrey
Wareing, Robert N.


Rogers, Allan
Watson, Mike (Glasgow, C)


Rooker, Jeff
Welsh, Andrew (Angus E)


Ross, Ernie (Dundee W)
Welsh, Michael (Doncaster N)


Rowlands, Ted
Williams, Rt Hon Alan


Ruddock, Joan
Williams, Alan W. (Carm'thon)


Salmond, Alex
Wilson, Brian


Sheldon, Rt Hon Robert
Winnick, David


Shore, Rt Hon Peter
Wise, Mrs Audrey


Short, Clare
Worthington, Tony


Sillars, Jim
Wray, Jimmy


Skinner, Dennis
Young, David (Bolton SE)


Smith, Andrew (Oxford E)



Smith, C. (Isl'ton &amp; F'bury)
Tellers for the Ayes:


Smith, Rt Hon J. (Monk'ds E)
Mr. Ken Eastham and Mr. Martyn Jones.


Smith, J. P. (Vale of Glam)





NOES


Aitken, Jonathan
Carlisle, John, (Luton N)


Alexander, Richard
Carlisle, Kenneth (Lincoln)


Alison, Rt Hon Michael
Carrington, Matthew


Allason, Rupert
Carttiss, Michael


Amery, Rt Hon Julian
Cash, William


Amess, David
Chapman, Sydney


Amos, Alan
Chope, Christopher


Arbuthnot, James
Churchill, Mr


Arnold, Jacques (Gravesham)
Clark, Hon Alan (Plym'th S'n)


Arnold, Tom (Hazel Grove)
Clark, Dr Michael (Rochford)


Ashby, David
Clark, Sir W. (Croydon S)


Atkins, Robert
Clarke, Rt Hon K. (Rushcliffe)


Atkinson, David
Conway, Derek


Baker, Rt Hon K. (Mole Valley)
Coombs, Anthony (Wyre F'rust)


Baker, Nicholas (Dorset N)
Coombs, Simon (Swindon)


Baldry, Tony
Couchman, James


Batiste, Spencer
Cran, James


Beggs, Roy
Currie, Mrs Edwina


Bellingham, Henry
Curry, David


Bendall, Vivian
Davies, Q. (Stamf'd &amp; Spald'g)


Bennett, Nicholas (Pembroke)
Davis, David (Boothferry)


Bevan, David Gilroy
Day, Stephen


Biffen, Rt Hon John
Devlin, Tim


Blackburn, Dr John G.
Dorrell, Stephen


Blaker, Rt Hon Sir Peter
Douglas-Hamilton, Lord James


Body, Sir Richard
Dunn, Bob


Bonsor, Sir Nicholas
Eggar, Tim


Boscawen, Hon Robert
Emery, Sir Peter


Boswell, Tim
Evans, David (Welwyn Hatf'd)


Bottomley, Peter
Fairbairn, Sir Nicholas


Bottomley, Mrs Virginia
Fallon, Michael


Bowden, A (Brighton K'pto'n)
Farr, Sir John


Bowden, Gerald (Dulwich)
Favell, Tony


Bowis, John
Fenner, Dame Peggy


Boyson, Rt Hon Dr Sir Rhodes
Field, Barry (Isle of Wight)


Braine, Rt Hon Sir Bernard
Finsberg, Sir Geoffrey


Brandon-Bravo, Martin
Fishburn, John Dudley


Brazier, Julian
Fookes, Dame Janet


Bright, Graham
Forman, Nigel


Brown, Michael (Brigg &amp; Cl't's)
Forsyth, Michael (Stirling)


Browne, John (Winchester)
Forsythe, Clifford (Antrim S)


Buchanan-Smith, Rt Hon Alick
Forth, Eric


Burns, Simon
Fowler, Rt Hon Norman


Burt, Alistair
Franks, Cecil


Butcher, John
Freeman, Roger


Butler, Chris
French, Douglas


Butterfill, John
Gale, Roger






Gardiner, George
Lilley, Peter


Garel-Jones, Tristan
Lloyd, Sir Ian (Havant)


Gill, Christopher
Lord, Michael


Glyn, Dr Alan
Luce, Rt Hon Richard


Goodson-Wickes, Dr Charles
Lyell, Sir Nicholas


Gow, Ian
McCrindle, Robert


Grant, Sir Anthony (CambsSW)
Macfarlane, Sir Neil


Greenway, Harry (Ealing N)
MacKay, Andrew (E Berkshire)


Greenway, John (Ryedale)
Maclean, David


Gregory, Conal
McLoughlin, Patrick


Griffiths, Sir Eldon (Bury St E')
McNair-Wilson, Sir Michael


Griffiths, Peter (Portsmouth N)
McNair-Wilson, Sir Patrick


Ground, Patrick
Madel, David


Gummer, Rt Hon John Selwyn
Major, Rt Hon John


Hague, William
Malins, Humfrey


Hamilton, Neil (Tatton)
Maples, John


Hampson, Dr Keith
Marland, Paul


Hanley, Jeremy
Marlow, Tony


Hannam, John
Marshall, John (Hendon S)


Hargreaves, A. (B'ham H'll Gr')
Marshall, Michael (Arundel)


Harris, David
Martin, David (Portsmouth S)


Haselhurst, Alan
Maude, Hon Francis


Hayes, Jerry
Mawhinney, Dr Brian


Heathcoat-Amory, David
Maxwell-Hyslop, Robin


Heddle, John
Mayhew, Rt Hon Sir Patrick


Hicks, Mrs Maureen (Wolv' NE)
Mellor, David


Hicks, Robert (Cornwall SE)
Miller, Sir Hal


Higgins, Rt Hon Terence L.
Mills, Iain


Hill, James
Mitchell, Andrew (Gedling)


Hind, Kenneth
Mitchell, Sir David


Hogg, Hon Douglas (Gr'th'm)
Moate, Roger


Holt, Richard
Molyneaux, Rt Hon James


Hordern, Sir Peter
Monro, Sir Hector


Howard, Michael
Montgomery, Sir Fergus


Howarth, Alan (Strat'd-on-A)
Moore, Rt Hon John


Howarth, G. (Cannock &amp; B'wd)
Morris, M (N'hampton S)


Howell, Rt Hon David (G'dford)
Morrison, Rt Hon P (Chester)


Hughes, Robert G. (Harrow W)
Moss, Malcolm


Hunt, David (Wirral W)
Moynihan, Hon Colin


Hunt, Sir John (Ravensbourne)
Mudd, David


Hunter, Andrew
Neale, Gerrard


Hurd, Rt Hon Douglas
Nelson, Anthony


Irvine, Michael
Neubert, Michael


Irving, Charles
Newton, Rt Hon Tony


Jack, Michael
Nicholls, Patrick


Jackson, Robert
Nicholson, David (Taunton)


Janman, Tim
Nicholson, Emma (Devon West)


Jessel, Toby
Norris, Steve


Johnson Smith, Sir Geoffrey
Onslow, Rt Hon Cranley


Jones, Gwilym (Cardiff N)
Oppenheim, Phillip


Jones, Robert B (Herts W)
Page, Richard


Jopling, Rt Hon Michael
Paice, James


Kellett-Bowman, Dame Elaine
Parkinson, Rt Hon Cecil


Key, Robert
Patnick, Irvine


King, Roger (B'ham NWield)
Patten, Rt Hon Chris (Bath)


Kirkhope, Timothy
Patten, John (Oxford W)


Knapman, Roger
Pawsey, James


Knight, Greg (Derby North)
Porter, Barry (Wirral S)


Knowles, Michael
Porter, David (Waveney)


Lamont, Rt Hon Norman
Portillo, Michael


Lang, Ian
Powell, William (Corby)


Latham, Michael
Price, Sir David


Lawrence, Ivan
Raffan, Keith


Lawson, Rt Hon Nigel
Raison, Rt Hon Timothy


Lennox-Boyd, Hon Mark
Redwood, John


Lightbown, David
Renton, Tim





Rhodes James, Robert
Summerson, Hugo


Riddick, Graham
Tapsell, Sir Peter


Ridley, Rt Hon Nicholas
Taylor, Ian (Esher)


Ridsdale, Sir Julian
Taylor, John M (Solihull)


Rifkind, Rt Hon Malcolm
Taylor, Teddy (S'end E)


Roberts, Wyn (Conwy)
Tebbit, Rt Hon Norman


Roe, Mrs Marion
Thompson, D. (Calder Valley)


Rossi, Sir Hugh
Thompson, Patrick (Norwich N)


Rost, Peter
Thorne, Neil


Rowe, Andrew
Thornton, Malcolm


Rumbold, Mrs Angela
Thurnham, Peter


Sackville, Hon Tom
Townend, John (Bridlington)


Sainsbury, Hon Tim
Townsend, Cyril D. (B'heath)


Sayeed, Jonathan
Tracey, Richard


Scott, Rt Hon Nicholas
Tredinnick, David


Shaw, David (Dover)
Trippier, David


Shaw, Sir Giles (Pudsey)
Twinn, Dr Ian


Shaw, Sir Michael (Scarb')
Vaughan, Sir Gerard


Shelton, Sir William
Waddington, Rt Hon David


Shephard, Mrs G. (Norfolk SW)
Wakeham, Rt Hon John


Shepherd, Colin (Hereford)
Waldegrave, Hon William


Shersby, Michael
Walden, George


Skeet, Sir Trevor
Walker, A. Cecil (Belfast N)


Smith, Sir Dudley (Warwick)
Walker, Bill (T'side North)


Smith, Tim (Beaconsfield)
Waller, Gary


Smyth, Rev Martin (Belfast S)
Wardle, Charles (Bexhill)


Soames, Hon Nicholas
Warren, Kenneth


Speed, Keith
Wells, Bowen


Speller, Tony
Wheeler, John


Spicer, Sir Jim (Dorset W)
Whitney, Ray


Spicer, Michael (S Worcs)
Widdecombe, Ann


Stanbrook, Ivor
Wiggin, Jerry


Stanley, Rt Hon Sir John
Wilkinson, John


Stern, Michael
Winterton, Nicholas


Stevens, Lewis
Wood, Timothy


Stewart, Allan (Eastwood)
Woodcock, Dr. Mike


Stewart, Andy (Sherwood)
Yeo, Tim


Stewart, Rt Hon Ian (Herts N)



Stokes, Sir John
Tellers for the Noes:


Stradling Thomas, Sir John
Mr. Tony Durant and Mr. Alastair Goodlad.


Sumberg, David

Question accordingly negatived.

Question, That the proposed words be there added, put forthwith pursuant to Standing Order No. 30 (Questions on amendments), and agreed to.

Mr. Deputy Speaker: forthwith declared the main Question, as amended, to be agreed to.

Resolved,
That this House supports the introduction of the community charge, the principles of which are manifestly fairer and simpler than those that now apply to domestic rates; welcomes the exemptions conferred on those who cannot be asked to pay and the generous discounts, rebates and increased income support available for those on low incomes; recognises that the unified business rating system introduces a valuable stability for non-domestic ratepayers; congratulates Her Majesty's Government on implementing proposals that will improve the accountability of local government by insisting that all who benefit from their services should have a say in their quality and cost; and notes that either a local income tax or a two-tax system based upon local income tax and capital value tax would be much more expensive to implement, much more unfair and make local government much less accountable.

Health Policy

Mr. Robin Cook: I beg to move,
That this House welcomes with enthusiasm the Prime Minister's pledge that no-one will go private again for medical treatment; invites the Secretary of State for Health to demonstrate his commitment to her pledge by withdrawing the provision for tax relief for private medical insurance, and by abandoning his proposals that self-governing hospitals should trade for private patients and that general practitioners should use practice budgets to purchase private treatment; notes that general practitioners on a ballot have rejected the contract offered by the Secretary of State by a majority of three to one; regrets that the Secretary of State has threatened to impose the new contract irrespective of this vote; and calls upon the Secretary of State to reopen negotiations on his proposal to increase capitation-based payments which will give doctors an incentive to seek longer patient lists.
Tonight's debate is prompted by two important developments in the health debate last week. Half the motion is inspired by the Prime Minister, who last week addressed the 1992 Committee in visionary terms about the Government's intentions for the Health Service. [HON. MEMBERS: "1922."] I stand corrected. Plainly, the 1992 committee of the Conservative party will be smaller than the 1922 Committee.
I give assurances to Conservative Members, who may be worried about the Opposition quoting the Prime Minister in a Supply day debate, that this is likely to be the only time that we shall welcome anything that the Prime Minister has said. I suggest to Conservative Back Benchers who are unhappy with the Government's proposals for the National Health Service that this could be the easiest wicket on which to rebel. After tonight's debate, should they vote for the Labour motion, they will be able to look their Whips straight in the eyes and say that they voted to support the Prime Minister's pledge—and a very remarkable pledge it was. She said, "No one will ever go private again".

Mr. Jerry Hayes: She did not say that.

Mr. Cook: I am interested to hear the comments of the hon. Gentleman, to whom I am happy to give way in a moment. I went to the Library and asked for a copy of the Prime Minister's speech to the 1922 Committee. I was advised that I could not have a copy because it was confidential. Since then, I have been distressed to see that, in the Government amendment, the reference to the Prime Minister is deleted.
I understand that the Secretary of State could not have heard the speech, because I believe that, like me, he is not permitted to attend those meetings. Perhaps some kindly Back Bencher——

Mr. Hayes: rose——

Mr. Cook: As we now have one on his feet, perhaps he can tell me whether the words reported were used, and if so, how many of his hon. Friends were so impressed by them that they have since cancelled their premiums to BUPA.

Mr. Hayes: Perhaps I can breach a confidence and tell the House that the Prime Minister said, "What I aim to do is to make the National Health Service so good that no one need ever go private again."

Mr. Cook: I have to confess that the hon. Gentleman made me uneasy when he began because I thought he said that he had taken to writing the Prime Minister's speeches on the Health Service, and that would be a sad loss to debates in the House.
If that is what the Prime Minister said, two questions obviously arise from it. The first is a small matter of whether, if it is what the Prime Minister said, she includes herself in the commitment. It is not clear, at the moment, whether she was implying the royal no one. The Prime Minister is much given to referring to herself as "one", but this would be the first time that she referred to herself as "no one". The truth is, as hon. Members on both sides of the House know if they have been round the doorsteps discussing it, that the public do not believe that they can trust the National Health Service in the hands of the Prime Minister because she takes good care never to trust herself in the hands of the NHS.
The second, and rather more important, question is whether the Secretary of State will sit down during the recess and rewrite the White Paper in the light of the Prime Minister's prediction according to the hon. Member for Harlow (Mr. Hayes). Certainly the White Paper needs urgent revision if she is right. For example, there is the proposal to provide for tax relief on private medical insurance. One can understand why the Secretary of State might be loth to let go of that commitment in the White Paper, because it is the only reference to the health needs of elderly people. Excise that and the White Paper will be absolutely about the needs of an age group who account for almost half of the entire health output of Britain. The Secretary of State must face reality. If no one need go private again, it would surely be cruel to deceive elderly people into paying for what they will not need. However, I note that shares in AMI Healthcare Group, the largest private hospital group, have leapt by a quarter in the month since the White Paper was published. There is not much faith there that no one will ever need to go private again.
Paragraph 9.6 of the White Paper says that general practitioners
will be able to use NHS funds to pay for treatment in the private sector".
What is that doing there if nobody need go private again? Why can NHS funds not be used to pay for NHS treatment in NHS hospitals?
Then there is the matter of paragraph 3.6 of the White Paper, which provides that opt-out hospitals may trade for private patients. I hope that the Secretary of State will save us from the humbug that this proposal will bring money into the NHS. Providing for private patients in NHS hospitals takes beds, staff and even blood out of the NHS.
That has already happened. A leaflet that has been distributed by Hillingdon district health authority advertises the authority's fixed price scheme. One can jump the queue in Hillingdon for a fixed price. For £370 one can have what is described as "removal of lumps and bumps". For £3,500, one can have a total hip replacement. On reading that leaflet, I felt a sense of rising outrage that a great public service that once prided itself on treating patients according to need was so reduced to chasing money that it touted its facilities by offering a fast track to those who could pay.
Against that record, no one will ever believe the Secretary of State and the hon. Member for Harlow when they promise that it is their objective to make the public


service better than private treatment. Fortunately, there are those in the Health Service who share that concern about where the Health Service is going.
I turn now to the other development last week which has prompted this week's debate on health.

Mr. Nigel Spearing: Does my hon. Friend agree that many people feel that the White Paper's ethics are distinctly rocky? This has driven me, as my hon. Friend may recall, to make a challenge at a public meeting in Newham town hall to any supporter of the Government to debate in my constituency, and his or hers, the neutral question—I hope that it is neutral—whether the Government's domestic policies, particular those relating to the Health Service, are compatible with Christian values. I have tried to make that challenge public, but have had no takers yet. I should be glad to meet Government supporters in Nottingham, Putney or anywhere else. I hope that Conservative Members will advertise that challenge far and wide, and that it will be taken up in the recess.

Mr. Cook: I well remember that occasion. At the end of of the debate, in order to be present for a vote at 10 o'clock in the House, I left Newham town hall by car and my hon. Friend left by bicycle. I arrived only two minutes ahead of him.
My hon. Friend made an eloquent and moving plea. It was a pity that the only way in which one could fill up the platform was with supporters of his case against the White Paper. I should like to share my hon. Friend's challenge to any member of the Government who wishes to go to Newham and take part in a public debate with my hon. Friend. I am sure that any such person will be made welcome by my hon. Friend—provided, of course, there is a reciprocal agreement by which my hon. Friend can go into that person's constituency and carry the message to his or her constituents.

The Secretary of State for Health (Mr. Kenneth Clarke): Come on.

Mr. Cooke: My hon. Friend the Member for Newham, South (Mr. Spearing) intervened just as I was about to move on to a matter to which, I am delighted to hear, the Secretary of State wishes to come. Only a couple of months ago, the right hon. and learned Gentleman made a triumphal statement to the House that he had secured agreement with the British Medical Association on the GPs' contract. He said:
I am glad to say that it has been my experience that … after a dispute is over, people appear to forget it entirely and no one can quite remember what the fuss was all about."—[Official Report, 5 May 1989; Vol. 152, c. 484.]
On this occasion, the GPs have not forgotten entirely what the fuss was all about. Last week, they voted by 24·1 per cent. to accept the contract and by 75·9 per cent. to reject it. That is not the kind of result for which one needs a recount to get the picture.
On radio last week, I heard the Secretary of State commenting, no doubt under the pressure of interview, that good doctors had nothing to fear from the new contract, that only the lazy doctor need fear—all 75·9 per cent. of them, I suppose. It is not just laziness that has

prompted GPs to put the contract into the incinerator. It is worth examining, more seriously than the Secretary of State has attempted to do, why they said no.
There is much in what the Secretary of State proposes to which I could say yes. I could give a mark of five out of 10 on the 10 major proposals for change. For reasons to which I shall come, I do not quite regard that as a pass mark. For instance, I would welcome his proposal to pay more to GPs who make their own night visits.

Mr. Kenneth Clarke: They are against that.

Mr. Cook: I well understand—the right hon. and learned Gentleman says that the doctors are against that. I think that he is right. I shall come to those proposals about which he is wrong. His concession that those night visits may be shared with nine colleagues is generous, and it is not unreasonable to ask GPs to do one night in 10 on call.
I agree also with what I understand the Secretary of State is trying to do on targets for screening, but the way in which he is going about it is misconceived. The problem is that the targets set by the Secretary of State for full payment—90 per cent. for child immunisation and 80 per cent. for screening for cervical cancer—are so heroic, so far beyond the present figure for most practices, that there is a danger that many doctors will simply give up trying.
I noticed at Question Time today that the Secretary of State said that most practices met those targets. I have since checked on those figures for district health authorities. Only one in England has reached 90 per cent. immunisation for children, and that is High Wycombe.

Mr. Kenneth Clarke: It is 70 per cent.

Mr. Cook: The Secretary of State says that it is 70 per cent. I concede that most district health authorities certainly meet the target of 70 per cent. I am sure that, in return, he will concede that for 70 per cent. the doctors get only one third of the payment. Full payment starts at 90 per cent., and only one district health authority is eligible.
This is not a matter on which it is necessary to have a party political debate. I refer the Secretary of State to the full scientific article in a recent edition of the British Medical Journal by a woman GP who, after working in a practice that has placed special stress on cervical smears and has been running a recall system for 15 years, still has not reached the target of 80 per cent. of the target population. Moreover, that GP was working in a suburban surgery. Achieving that target would be even more difficult in inner-city areas.
I should like to have the attention of the Minister of State, the hon. and learned Member for Putney (Mr. Mellor), who, I well understand, will wish to impress himself on the powerful friend next to him—the Secretary of State. In a television debate, the Minister of State made a statement that at the time rendered me speechless. He said that there was no evidence that it was more difficult to meet screening targets in areas of social deprivation.
I have since been through the figures for district health authorities. The percentages of immunisation by district health authority reads like a map of Britain by socio-economic indicators. The three lowest areas of immunisation are Merseyside, inner London and Manchester, none of which reaches 70 per cent. The three highest districts are Huntingdon, Winchester and High Wycombe. The only conclusion that one can draw from


the way in which the Government have devised the centres for screening is that they are providing incentives for GPs to move into those areas that already have the most GPs and the fewest health problems.
It is not that the contract flopped on those matters. Anyone listening to GPs, rather than lecturing them, already knows what the key issue was: the proposal to increase the proportion received by GPs from capitation fees. GPs already get almost half their income from payments directly related to the numbers of patients. Under the proposal in the new contract, that proportion will increase from almost half to three fifths. This will give even more to those doctors who go for more patients, at the expense of those GPs who limit themselves to the number of patients that they can handle to a professional standard.
This is a flat reversal of a policy pursued for 20 years by successive Government, whether Labour or Conservative, which has aimed at reducing the number of people on patient lists. The Secretary of State proposes to turn the clock back, not to the last Labour Government, but to the Labour Administration before that. One must go back to 1966 before finding a time when the capitation element was so high.
The Secretary of State understands, of course, that more patients means more patient care. We know that he understands that, because he vigorously denies that his proposal can result in more people on each patient list. He claims that he is giving doctors the incentive to increase patient lists, while at the same time assuring patients that it cannot happen—that there will not be any more patients to go round, so the average will stay the same.
Unfortunately, I have to warn the Secretary of State that the number of GPs may not stay the same—at any rate, it will stop expanding. Already, practices from Devon to Glasgow have decided not to proceed with the additional partnership that they had intended to advertise. Their response to the Secretary of State's new contract is entirely rational. They are responding in Thatcherite terms to the financial incentives that they have been given to lengthen the patient list in the practice—although, as they understand, the result in terms of patient care is utterly perverse.
There is a simple way for the Secretary of State to demonstrate his good faith on this question of longer patient lists. He will be aware that the BMA, which he keeps telling us is opposed to any change, has proposed that the ceiling on patient lists should be reduced from 3,200 to 2,500. I ask the Secretary of State whether he will accept that reduction in the upper limit on patient lists. Will he take that obvious precaution to prevent GPs from doing what he assures us he does not want them to do—indeed, he keeps assuring us that they cannot do it—namely, going for longer patient lists? If he will not, there is an obvious conclusion to be drawn. The Secretary of State has designed, as a matter of policy, a contract that will sharpen the competition between GPs for patients, with an incentive to go for longer patient lists, and he has no intention of putting in their way an obstacle to prevent them from doing so.
The last word on the contract, however, must be left to an academic study which the Secretary of State himself chose as relevant to the new contract. On 27 June, in answer to a written question, the Secretary of State said:
Recent research by York university's centre for economics has demonstrated the wide range of quality of

service to patients provided in different parts of the country under the old contract."—[Official Report, 27 June 1989; Vol. 155, c. 422.]
The Secretary of State is perfectly correct that the study drew attention to the variations in quality provided by GPs and highlighted the fact that the poorer regions of Britain get a poorer service from GPs.
It is perhaps unfortunate that whoever drafted the reply for the Secretary of State did not draw his attention to the full press comments of the authors of the report, who said:
The new contract … is likely to widen the gap even further … Our prediction is that in five to 10 years there will be an even greater difference in standards of service.
It is a mark of desperation on the part of the Secretary of State to find friends for his new contract that he is driven to cite academics who believe that his contract will make matters worse.
This is a short debate, and I wish in conclusion to discuss the response of the Secretary of State to the result of the ballot. As I understand the Secretary of State's position, as far as he is concerned, the BMA need not have bothered balloting members. The GPs will get the contract whether they want it or not, because he will impose it on them. It does not count that 76 per cent. of GPs oppose the contract; nor, for that matter, does it count that, last month, the National Association of Health Authorities found in its opinion poll survey that 90 per cent. of patients were satisfied with GPs. But the Secretary of State reserves the right to know better than 76 per cent. of GPs and 90 per cent. of patients.
The Secretary of State will be aware that there is a small problem in imposing the contract. It is not for him to impose it; he requires a vote in the House in the autumn. I am happy to say that there has fallen into my hands a letter which turns out to be a letter from the Secretary of State to all his hon. Friends, which he ends by wishing them a good recess. Let me take this opportunity to associate myself with that wish to Conservative Back Benchers. I wish them a happy recess in their constituencies explaining to GPs why they propose to ignore the results of the ballot and vote to impose the contract all the same. Not that either they or we need be surprised by the Secretary of State's reaction: it is utterly characteristic and entirely in line with the attitude that he has adopted to the NHS since he returned to his post.
The Secretary of State presides over the largest resource of professional advice and scientific expertise anywhere in Britain. It is a matter of regret that he has shown no interest in listening to any of it. This year, it is the turn of the GPs. Last summer, it was the turn of the nurses who had imposed on them the guidelines in the regrading agreement. Last autumn, it was the turn of the opticians, who warned him that ending free eye tests would result in charges of more than £10 and a drop in the number of tests. I vividly remember the Secretary of State assuring the House that he did not believe them. This spring has been marked by the refusal of the Secretary of State to listen to the chorus of criticism of his White Paper from nurses, doctors, patients and the rest of the public.
The right hon. and learned Gentleman's own limited tolerance of criticism was expressed vividly in the circular that he sent out on consultation on the White Paper. This is how he defined consultation:
I look forward to receiving contributions, constructive criticisms and alternative suggestions"—
so far, so good—


so long as they are aimed at putting the White Paper proposals into practice by 1991.
In other words, consultation is welcome as long as those consulted agree with the proposals. The right hon. and learned Gentleman's impatience of any other criticism was perfectly caught this afternoon when he told my hon. Friend the Member for Halifax (Mrs. Mahon) that she was not qualified to vote on whether a hospital should opt out. The Secretary of State has defined a system of opting out that matches his view that his opinion is the only one that matters: he is the only person with a vote on whether a hospital should opt out.
It should not surprise anyone that the Secretary of State has chosen to ignore a defeat of three to one. It is of a piece with his management style, which, we are bound to suspect, he copies from the Prime Minister. They are both stubborn and opinionated in their own views and contemptuous and dismissive of the views of everyone else. It is a style of government of which the nation is now heartily sick, and I warn the Secretary of State that if he persists with it, he may succeed in his given task of undermining the NHS but he will almost certainly succeed in undermining support for the Government.

The Secretary of State for Health (Mr. Kenneth Clarke): I beg to move, to leave out from "House" to the end of the Question and to add instead thereof:
welcomes the Government's proposals for reform in the National Health Service which will bring all parts of the health service up to the very high standards now achieved by the best, put the needs of patients first and secure the best value for money; recognises that to make the health service more responsive to the needs of patients as much power and responsibility as possible need to be delegated to local level in future, whether in directly managed or self-governing National Health Service hospitals; looks forward to large general practitioner practices being able to apply for their own budgets to obtain a defined range of hospital services so as to improve the quality of service to their patients; and fully supports the Government's decision to proceed with the implementation of the general practitioners' new contract, the contents of which were agreed with the general practitioners' leaders on 4th May.
The hon. Member for Livingston (Mr. Cook) has made his last speech before the recess, which, as he said, we all confidently expect to come shortly. The hon. Gentleman opened the debate rather like a football player who expected to be playing an end of season game before a rather desultory crowd. He produced a speech and an Opposition motion which simply do not contain any new or good ideas. He showed yet again that his role in echoing the criticism that exists outside the House of our NHS reforms is to represent the views of those who have absolutely no proposals of their own to introduce. The hon. Gentleman continues to do that.
I can recall being in opposition and I know of the difficulties involved in finding ways in which to fill the time on Supply days. The hon. Gentleman was reduced to going through his newspaper clippings to see what has happened in the health world over the past few weeks. He has composed an extraordinary motion combining a quotation from the Prime Minister at a meeting of the 1922 Committee with some of the newspaper reports that followed the GPs' ballot on their contract. His speech, though concise, hardly covered the great problems of the Health Service that we are tackling at the moment.
There is a problem with the quotation from the Prime Minister. As the hon. Gentleman said, I am not allowed to attend meetings of the 1922 Committee and, by singular good fortune, I seem unlikely to be attending a meeting of that committee for some little time yet. I have therefore had to rely on my hon. Friends for the quotation. Not for the first time, my hon. Friends do not entirely agree. My hon. Friend the Member for Harlow (Mr. Hayes) has helpfully given us his account of what was said at the meeting but the recollection of my hon. Friend the Member for Derby, North (Mr. Knight) is that the Prime Minister said, "The National Health Service will be so good that no one will want to go private again." [HON. MEMBERS: "Yes."] That recollection seems to be shared by the majority of my hon. Friends on the Back Benches.
I am not surprised by that quotation, although I was not there to hear it and I did not know that my right hon. Friend was going to make it. It touched on conversations that my right hon. Friend and I had from time to time during the review. It is obvious that in our reforms to improve the NHS we shall aim at the best standards achieved anywhere and pose a formidable challenge to the private sector to maintain its standards to keep its appeal to those patients who want to use it for health care.
We intend that the better National Health Service that we aim to create will not set itself lower standards or goals than the private sector aims to achieve. The private sector would have less to fear from an unreformed NHS coping with out-of-date organisation and management and coming under ever-increasing strain to keep up with demand, despite all the extra resources that the Government keep pouring into it.
Patients turn to the private sector for two reasons. First, they exercise their undoubted choice to opt for private medicine for their family and secondly because of their perception of the shortcomings and inadequacies of the NHS. People have an exaggerated view of those inadequacies because they are fed by Opposition spokesmen who seize on local problems in this giant service and give the impression that waiting lists and shortages are a universal problem, when they are usually the result of purely local problems.
It is not new for the Opposition to feed critical views of the Health Service to the general public. I have said before that the best allies of private medicine in the past 10 years have been Barbara Castle and the National Union of Public Employees, whose behaviour in the late 1970s was of particular help. The Labour Front Bench team continue that unintended support for the private sector by defending the NHS against any attempt to improve it and continually producing a highly coloured version of the difficulties facing patients. We shall tackle the problems of the Health Service, and as a result of our reforms it will be a much more powerful competitor of the private sector.

Mr. Allan Rogers: The Secretary of State said that there were two reasons why people choose the private sector rather than the NHS. First, he said that they want to exercise their choice and secondly, that they perceived inadequacies in the NHS. Does he accept that one of the main reasons why people use the private sector is that they can jump the queue and get in early? They cheat the queue.

Mr. Clarke: That is why we need reforms to tackle the queues and to reduce waiting times. As my hon. Friend the


Minister of State said at Question Time, we could do that by making all operating theatres as efficient as the best. To resist reform is to preserve excessive waiting times and queues, which helps the private sector.
The hon. Member for Livingston included the quotation in his motion merely to make the unoriginal point about tax relief for the elderly, which we included in our White Paper. As he knows, the case for tax relief is based on our belief that, while we intend to make the NHS a competitor of the private sector and able to offer high standards, it is right that patients should have the choice. As society becomes increasingly affluent, people will have more disposable income and some will wish to choose private medicine for various reasons, including convenience and personal predilection. We have offered tax relief to address the particular injustice felt by many elderly people who chose private medical insurance during their working lives but then found that the premiums rose steeply in retirement, when their income dropped. I do not understand the disporportionate attack that is always made on the tax relief proposal, which has been widely welcomed by many elderly people and is a part of the White Paper that has caused the least fuss among the non-ideological public.
The hon. Gentleman raised the more substantial item of the GPs' contract. I am grateful to him for opening up that issue, because it enables me to explain it. I am grateful to him for conceding that he recognises the case for a new contract and that he sees merit in our proposals. He is therefore urging the General Medical Services Committee to accept the need for a performance-related contract which is more in tune with the needs of the late 1980s.
I would have preferred to reach an agreed contract with the GPs and the GMSC. My predecessors and I have bent over backwards to achieve just that. The origins of the new contract go back to the Green Paper of three years ago. Many public meetings were held as the basis for consultation. We had 19 meetings with the negotiators and 110 hours of discussion on 38 documents. Eventually, we reached agreement with the formidable team of GMSC negotiators representing GPs.
The negotiators commended our package to GPs. At a local medical committee conference, it was only just rejected by local medical committee representatives in a tight vote. Then a general ballot was held. So far as I can see, although the package continued to be commended, nobody made any attempt to campaign in support of the commendation. Few local medical committees tried to explain to GPs who had not followed the details where we were in the negotiations.
In the past few weeks I have met GPs from rural areas who thought that rural payments would be abolished and did not know that we had reinstituted seniority allowances in response to the negotiators' requests. As a result of widespread public campaigning against the reforms, there was a heavy vote against the commendation.
The Opposition must address the problem and say what we should do in response to that ballot. Undoubtedly, the Labour party will say that we should accept it and start all over again. That, indeed, is the position of the GMSC, which I met yesterday. I met exactly the same negotiators with whom I reached agreement on 4 May. At that time they left with what they regarded as a satisfactory package of arrangements which they commended to GPs. [Interruption.] I was at the meeting. The negotiators do not require the hon. Member for Peckham (Ms. Harman)

to speak on their behalf. They had agreed a satisfactory package which they commended to their members. Faced with a vote which did not endorse their commendation, they came back to me yesterday wishing to reopen negotiations on every item on which we had reached agreement on 4 May. [HON. MEMBERS: "Why not?"] They suggested a timetable that would take us until Christmas for reconsidering the whole matter.
The hon. Member for Livingston was good enough to say that he supports the principle of higher payments for the majority of practitioners who make their own night visits. The negotiators intend that to be the subject of fresh negotiations. He said that targets were a desirable principle, although he raised some points about the details, which I shall deal with in a moment. They wish to reopen negotiations about the basis for incentive payments for higher rates of vaccination and cervical cytology. They wish us to reconsider basic practice allowances although we had already made considerable changes. I asked whether the 26-hour availability for direct contact with patients each week was settled, but they said no, that could not be regarded as such. They wish to reopen negotiations on that as well as on capitation, to which the hon. Gentleman referred and to which I shall return.
The negotiators are in no position to agree to any changes. They already have many concessions in the bag; concessions which I made last time and which they offered to members. They now take them as read and wish me to contemplate further concessions although they have no negotiating mandate. Scarred by its experience, the GM SC did not feel able to say that it would be able to agree to any of this. Presumably, I was to make concessions on all those fronts, including those supported by the hon. Member for Livingston, and then it would put it to the local medical committees, and perhaps, in due course to another ballot of general practitioners.

Mr. Spearing: That is democracy.

Mr. Clarke: No, it is not democracy. I have to say that it is damn near anarchy.
I understand that in settling, in this case, the basis of payment to independent contractors, or more normally the terms and conditions of employees, that is a negotiation in which the person who pays and the person who is being paid have an interest. Obviously, it is right to seek a compromise between my role, which is to look after the interests of the patients and the service and to have a contract that stimulates higher standards, and the GMSC's legitimate role to have something that is acceptable to its members. If we concede everything and the GMSC keeps going back for a vote, we will wind up with a contract that is so completely dominated by those things that make life comfortable for the doctors and the medical profession that we will sacrifice all the aims of higher quality care, which must be a legitimate interest for a sensible and responsible Government to look after in such discussions.

Mr. Spearing: rose——

Mrs. Alice Mahon: rose——

Mr. Bob Cryer: rose——

Mr. Clarke: I shall give way in a moment, but I want first to deal with two matters that I mentioned, which appear to be the only major doubts of the hon. Member for Livingston—targets and capitation.
It is a fond belief on his part that they are the only matters that need to be reopened at the request of the GMSC. I have said that the 70 per cent. target could be hit by most practices in England. I believe that is so in the case of vaccination. I introduced that as a big concession last time, because it is comparatively easily obtained by most of our English practices. My understanding is, however, that many Welsh and Scottish practices will have to raise their performance to get there—as, too, will some English practices. Therefore, a lower target was justifiable and I made a concession. It will stimulate practices to raise their performances to those that are being readily achieved in wide parts of England.
The 90 per cent. target is a World Health Organisation target. It is always stated that our agreed aim is for the National Health Service to be one of the best health care systems in the world. I cannot accept that the performance targets for vaccinations in our National Health Service should be below the level accepted by the World Health Organisation. The hon. Member for Livingston may be right—I have not looked it up—in saying that only High Wycombe hits 90 per cent. Why on earth should High Wycombe be the only place in the United Kingdom where it is legitimate for the GPs to strive to reach the best international standards? I believe that the hon. Gentleman should be committed to my principle of a performance-based contract.
When people looked around for other reasons why the GPs rejected the contract, the capitation argument was raised. As the hon. Member for Livingston said, we are talking about a contract where capitation is by far the largest single element. We are moving from 48 per cent. to 60 per cent., although that includes some new elements that we are counting as capitation. I do not accept, for the reasons that the hon. Gentleman has given, that that will have the slightest effect on average lists. The situation in the 1960s must be compared with one where we will make it much easier for patients to change their practice and for them to have access to information about the kind of services that their doctors will provide. We believe that it is right to spread the work load more fairly and to reinforce the efforts of those GPs to attract and retain their patients. However, they will not do so if they build up enormous lists. Any GP with an average or near-average list will strive to get performance payments that arise under the other part of the contract.
The hon. Member for Livingston claimed that partners are being turned away in some practices and that the number of GPs is being reduced. If that is happening, it can only be because the GPs have been carried away with their own campaigning. The only reason for not replacing a partner who has retired is that GPs are taking the view that they can earn more with four partners in the practice than they can with five. They are, therefore, somewhat irresponsibly deciding to increase their work loads, not to replace a partner when he retires and to cut back on the amount of time that they give to their patients. However, GPs will not benefit from such actions. They will lose their patients to those other GPs who will be inspired by the contract to set themselves a reasonable work load and to go after the performance payments that we are making for a good delivery of service to patients.

Mr. Robin Cook: If the Secretary of State accepts that longer patient lists would be at the expense of patient care and that it is not his intention that GPs should go for longer patient lists, will he accept the proposal that the upper limit for patient lists should be reduced from 3,200 to 2,500? If not, why not?

Mr. Clark: The extent to which any given number of patients reduces or does not reduce the amount of time given to patients depends on the amount of time that the doctor puts into his practice. We know from the last study of GPs that the average commitment of a GP to his practice is 38 hours a week. The contract requirement is for a minimum of 26 hours direct availability to patients. I do not see, however, why a GP who wants to have a larger than average list could not make himself available for more than 26 hours and still provide an adequate standard of service.
Patients will judge for themselves whether the amount of time that they receive from their doctors is adequate. I hope that, as we open the eyes of more patients as to what can be achieved by modern general practice, they will be particularly attracted to those doctors who have good standards of vaccination, who go in for the health promotion and the prevention of disease that we are stimulating and who offer minor surgery and all the other advantages to patients.

Mr. Spearing: The Secretary of State has ranged at great speed over other matters, but I wish to take him back to his complaint that the doctors wished to take up matters after the ballot. Does he recall that about 40 years ago, when the Health Service was founded, one of the big issues was that doctors were to be independent contractors and not employees? Is not the Secretary of State's complaint completely invalid, because he must accept that they are independent professional contractors providing a professional service, not employees like people on the railways or on the docks?

Mr. Clarke: That works both ways. I accept that they are independent contractors. However, I do not accept the Labour party's claim that, if one is an independent contractor, one is entitled to dictate from one's own side of the table all the terms of the contract.

Mr. Spearing: I am not saying that.

Mr. Clarke: That is exactly what the Labour party is saying. The motion says that, if the doctors do not want it, the matter should be reopened and we should carry on producing terms until they are wholly acceptable to the GMSC. Is the Labour party saying that, if they vote against it 60:40 next time, it might accept that some duty falls on the Government to ensure that the patients are looked after?

Dame Elaine Kellett-Bowman: Will my right hon. and learned Friend give way?

Mr. Clarke: There are two sides to the contract. The hon. Member for Newham, South (Mr. Spearing) is right to say that history repeats itself in many ways. The extraordinary way in which the Labour party—bereft of any ideas of its own on the Health Service—simply follows through newspaper cuttings of what the GMSC or the BMA is currently arguing is a strange reversal of previous form.
I shall not go back to the 1970s, when the Labour party had great battles with the doctors and the nurses and did not accept votes and the terms and conditions that they wished. I shall not go back either to the 1960s, when the Labour party had equally dramatic battles with the GPs, among others, and it settled the last contract when faced with industrial action by the GPs. It started with the whole National Health Service in 1946.
It is astonishing, when one looks at the present controversy, how much history has so far repeated itself. In March 1946, the BMA's main objection to the then Labour Government's White Paper was that it had not been consulted during the course of it being drawn up. Aneurin Bevan was repeatedly attacked for what was described as a dictatorial attitude and his insistence on imposing things on the profession. The BMA's main argument was that the new health centres should be introduced on an experimental basis and not introduced nationwide. A BMA member even compared Aneurin Bevan's proposals to a "regime which is now coming to its sorry end in Nuremburg". I regret to say that, in reply, Aneurin Bevan called them
a small body of politically poisoned people".
That is language to which my hon. Friend and myself would never resort.
About 56 per cent. of doctors opposed co-operation with Nye Bevan's proposed creation of the National Health Service. Indeed, they voted by 9:1 against accepting the terms and conditions offered in the Health Service. However, history has not repeated itself entirely, because I do not recall that the Labour party was on the side of the nine. Today's Labour party—the very much lesser figures who occupy their predecessor's shoes—are prepared to accept a re-run of history so far——

Mr. Nicholas Winterton: rose——

Dame Elaine Kellett-Bowman: rose——

Mr. Winterton: I am grateful to my right hon. and learned Friend——

Dame Elaine Kellett-Bowman: Hang on—[Interruption.]

Mr. Winterton: I take my right hon. and learned Friend's remarks seriously. There is considerable sense in what he says. However, will he pay credit to the overwhelming majority of general practitioners who play a vital part in the health care of this country and will he admit that they have done so since the foundation of the National Health Service? Will he also admit that the overwhelming majority of people in this country have confidence in our general practitioners?
I hope that, later in his constructive speech, my right hon. and learned Friend will say that he is prepared to enter into on-going discussions with the general practitioners to seek a satisfactory solution which, I believe, will be in the interests, not only of the doctors but of the patients.

Mr. Clarke: I am grateful for part of my hon. Friend's advice because I should acknowledge that our general practitioners provide a valuable service to the public and are committed to the National Health Service. Many of them voted as they did, believing that they would lose money through our proposals, when they will not. We are proposing to reward the services and work load that the

best doctors already operate. Many of them will benefit from our proposals. It is up to the GMSC and ourselves—or certainly it should be—to explain yet again to the doctors what we have agreed. As I made clear yesterday, I am prepared to listen to the GMSC if it comes forward with any proposals, and to explain the difficulties.

Dame Elaine Kellett-Bowman: Will my right hon. and learned Friend give way on that point?

Mr. Clarke: Yesterday I was faced with negotiators who have now lost all their negotiating mandate. There is nothing that they can conceivably agree to. They do not know what they want and wish to reopen the whole thing over a prolonged time scale, presumably then resorting—as the Opposition wish—to another attempt to ascertain whether that is acceptable.

Dame Elaine Kellett-Bowman: Is my right hon. and learned Friend aware that the trend that he referred to about five minutes ago of patients transferring to doctors who offer a better service is already happening in my constituency, where some go-ahead GPs have set up exceptionally good premises, with a well-man and well-woman clinic, a hyper-tension clinic, their own night service and a 24-hour on-call service? Patients are already transferring to that practice from practices that do not supply such facilities. The doctors who are supplying these facilities will be infinitely better off in the future because at the moment they are providing those facilities out of sheer professionalism, but in the future they will be paid for what they are doing.

Mr. Clarke: My hon. Friend knows and supports the fact that we will make it easier for patients to change practices and that we will make it possible for them to be given more attractive information about what their practice offers.
The position of the Opposition and of some people in the profession is that rewards to attractive practices, such as my hon. Friend has just described, should not be so great in order to protect the position of those who are not offering new services or achieving the higher standards. That is not a glorious position for either the Opposition or the profession to accept. Indeed, it was not the position adoped by the GMSC. I pay tribute to the negotiators that I faced on 4 May, because they drove a hard bargain on behalf of their GPs. They got me to make concessions which, frankly, I would not otherwise have been minded to make, and they came up with a fair package. We should now explain to the doctors that we have achieved a fair balance in the interests of the patients as well as of themselves.
We are drawn over the history of these matters partly because we are going over the history of the Labour party's objections to our reforms as they pick them up as we go along. However, history needs not repeat itself. Indeed, it is not doing so, because the Labour party is on the wrong side of the barricades at the moment. As I keep saying to the BMA, the barricades should come down. It is a needless and continuing controversy——

Mr. Spearing: It was the Secretary of State himself who put up those barricades.

Mr. Clarke: If the BMA would abandon its extremely indiscreet newspaper campaign, if its members would stop frightening their elderly patients and if we got back to the


undoubted agreement that exists between us on the future of the National Health Service and the principles upon which it is based, we could make progress.
Behind all the newspaper cuttings which the hon. Member for Livingston draws upon and the continuing controversy over the contract, the fact is that the common interest in the Service between many doctors and other professionals and the Government, and the common interest among most people in this country in seeing a better Health Service, is being put into effect. Yet again, as on previous occasions, I must advise the hon. Gentleman that he will be horrified to hear that the implementation of our White Paper reforms is going smoothly and well.
I shall shortly be sending members of all parties a briefing pack giving them all the detailed information that they require. The pack has recently been sent to managers and itemises in considerable detail the progress that has been made in preparing for the reforms and in putting them into place.
The review has already changed the climate in the Health Service to an extent that I would never had expected. I have never known a service which, in the past, has been so resistant to change, engaging in planning for so much change on such a wide scale.
Although all our debates are dominated by our unfortunate problems with the medical profession, we should remember that there are many other people in the Service. The chairmen and the managers of the National Health Service authorities are extremely keen on our reforms and are pressing on with them purposefully and well. There are wide agreements between doctors and nurses, who have not been mentioned so far, on a number of systems——

Mr. Ian McCartney: It is the Secretary of State who appoints those chairmen.

Mr. Clarke: I shall remind the House yet again that the doctors and the nurses—indeed, the great bulk of both professions—support the need to introduce new financial management systems. They support the need for clinical audit as a form of quality control. They all support the need to devise better methods of distributing our resources so that the money follows the patient. We are still discussing the details of our contract system.

Mr. Cryer: Will the Secretary of State give way?

Mr. Clarke: In my judgment about 80 per cent. of our White Paper proposals have achieved pretty universal acceptance and are now being put into place.

Mr. Cryer: Yet again, will the Secretary of State give way?

Mr. Clarke: No.
There continues to be controversy about self-governing hospitals and about GPs' practice budgets. They are the very systems that are causing most controversy, but they are also the areas in which we are proceeding most cautiously. We have said that we will expand them where we have people who wish to make a go of it, who see the potential and who are prepared to work hard with us. I expect only a limited number in 1991. However, as the volunteers develop those ideas, I believe that their great potential will be shown and it will be recognised that that

is the way to organise both hospitals and practices to take advantage of the new systems, and that that will eventually move the debate on.

Mr. Cryer: rose——

Mr. Robin Maxwell-Hyslop: rose——

Mr. Clarke: No, I shall not give way because I have been speaking for too long.

Mr. Maxwell-Hyslop: I am grateful. Would my right hon. and learned Friend tell the House why the letter from Mr. Nichol in his Department, which said that expressions of interest in going to National Health trust status by hospitals should be referred to regional health authorities for their comments before being sent to his Department when, in fact, those authorities have been completely bypassed, and that the expressions of interest have been sent to his Department without being placed before the South Western regional health authority, for instance, whose members have had no opportunity therefore to comment on them, contrary to the letter which was sent out?

Mr. Clarkerose: rose——

Mr. Cryer: On a point of order, Mr. Deputy Speaker. I wonder whether we could have a brief Adjournment. The Minister of State has been giving information to the Secretary of State who clearly has not a clue about the point that has been raised and he obviously needs some conversation with the specific Minister so that he can answer his hon. Friend.

Dame Elaine Kellett-Bowman: That is not a point of order.

Mr. Deputy Speaker (Sir Paul Dean): Order. The House is anxious to get on with the debate. I call Mr. Secretary Clarke.

Mr. Clarke: I know that the hon. Member for Bradford, South (Mr. Cryer) is always desperate to get his name into Hansard, but I have never known him reduced to quite that desperation before.
Duncan Nichol, the chief executive of the Health Service, is perfectly entitled to ask for expressions of interest in self-governing status. Such expressions of interest are being handled at regional level in the first place and are then being passed on to us with the comments and judgment of the regional health authority management.
I understand that there is some controversy in the south-west about exactly who has seen them, but I have no doubt that that matter could properly be sorted out by the south western regional health authority, which is responsible for managing its own affairs. The process followed by Mr. Duncan Nichol, the chief executive of the Health Service, was perfectly proper and carried out with my knowledge and approval. He produced 178 expressions of interest in self-governing status from people who saw the potential of what we are proposing for their particular units.
The debate will move on as implementation proceeds. I have no doubt that a momentum for change will build up inside the Health Service and will at last oblige the Opposition to move on and to face up to the fact that the actions of my right hon. Friends and myself are the actions


of friends of the National Health Service who see the way in which it should be reformed to improve the standards of service for patients in future years.
I believe that the Labour party and its allies and the more reactionary people in the professions and elsewhere will be overtaken by great events in the National Health Service over the coming years. The debate will be regarded as a footnote to the events taking place at the moment. I believe that the GPs' contract will shortly be resolved to the satisfaction of the best doctors and certainly their patients. That will be only the first step in a great process of reform which the Labour party cannot stop and of which we will be extremely proud when we have completed it.

Mr. William McKelvey: I make a brief foray into the debate on behalf of Opposition Back-Bench Members to say that today the alternative select committee on Scottish affairs published its first report on the Health Service in Scotland. I recommend that the Secretary of State reads the document, which contradicts much of what he said. The vast majority of the evidence that we collected from people in Scotland working in and for the Health Service, from those who have benefited from the Health Service and from medical practitioners bears out much of what was said by my hon. Friend the Member for Livingston (Mr. Cook) from the Opposition Front Bench.
Much of the document is relevant only to Scotland, and I shall not bore the House with details in which hon. Members may not be particularly interested. But there are great similarities between the Health Service in Scotland and in England and great comparisons are made in our document. I shall read out some of the document, a copy of which is in the Library. Additional copies can be purchased from my good self at the price of £1·50. The reason for the charge is that the alternative select committee for Scottish affairs has to provide its own funds for its investigations, due to the failure of the House to set up a proper Select Committee on Scottish Affairs. As we are not allowed to be financed by the establishment, perhaps on Thursday the new Leader of the House will be convinced to attempt to get Scottish Conservative Back-Bench Members interested in the Health Service and all Scottish affairs, and to organise a proper Select Committee to look into these matters.
We did quite well with the resources that we had, and the document is quite well presented. In its evidence to the committee, the British Medical Association voiced some of its worries. It said:
The introduction of an extended internal market, could have a number of adverse effects for consumers:

1. More patients would have to travel more often.
2. There could be particular problems for the elderly of those who have young children and friends/relatives could find visiting more difficult.
3. Post-operative follow up at out-patient clinics might not be carried out by the same consultant who performed the surgery."


The document continued
The Committee was also unconvinced by the assertion that the form of internal market being proposed would increase 'consumer' choice. At present the decision as to where treatment will take place is made individually between the patient and his or her GP or consultant. The patient's relatives may also be involved, especially if the patient is mentally ill, mentally handicapped or elderly. If Health

Boards entered into trading agreements with each other or with third parties to provide blocks of patient services, this individual choice would inevitably be reduced.
That is quite the opposite of what the Secretary of State was saying at the Dispatch Box. That difference should be noted.
The report continued:
Some witnesses raised concern that English codes of practice were inappropriate for Scotland. The Scottish Association of Local Health Councils pointed out that Scottish lists sizes are approximately 1,600, whereas English list sizes are approximately 2,000, that is 25 per cent. larger. The minimum list size for a General Practitioner to receive a budgetary allowance is 1,100. However there are increasing concerns that this is far too small.
I know that discussions are taking place, and perhaps agreement is being reached on these matters.
The report continued:
North American researchers have shown how volatile such budgeting would be if implemented at this level (for example, R. Scheffler writing in the Lancet, 1989). Alain Enthoven, the American economist who first proposed the concept of the internal market, has recently suggested in the British Medical Journal that the minimum size would have to be 50,000 if the scheme was to be operational. The Committee is concerned that if the minimum list size which determines the viability of budgetary-based trading is not known, then the proposals themselves will not be viable. The Committee recommends that some degree of experimentation is undertaken before any policy is implemented.
I picked up in my mail the "Parliamentary Newsheet" from the Market Research Society—a document which I seldom read or quote. It contained an interesting article entitled "GPs' reaction to the White paper".
It said:
Recent research by the British Pharmaceutical Market Research Group has found that GPs have become considerably more negative in response to the Government's White Paper proposals in the period since those proposals were first published. This is the overall finding of a study of 466 GPs.
An earlier study was conducted immediately after the publication of the White Paper and revealed that half of GPs questioned disagreed that there were any patient benefits. That figure has now risen to 84 per cent. disagreeing that patients would benefit overall.
That was despite, or perhaps because of, the Government's propaganda on the White Paper, and their explanations, which were certainly not plausible to general practitioners or to members of the public.
The most mail that I have had for a considerable time comes from ordinary people who write to me—not the photocopied letters or postcards provided by general practitioners—with real concern that the Government are not genuinely attempting to improve the lot of patients in the National Health Service. My constituents are worried that we are turning the National Health Service into a profit-making business and putting that before patient care. I have received hundreds of letters, which I shall eventually dispatch to the Secretary of State, as I have promised my constituents, so that he can read some of the comments in them.
When the Secretary of State outlined his discussions with the British Medical Association, and said that an agreement had been reached by its representatives and then overturned by a small majority at its subsequent conference, he did not provide the figures. I agree that there was a small majority. On 21 June 1989, a special conference of local medical committees voted against by 166 to 150. In anybody's language that was a majority, so


the representatives of the local medical committees did not agree with the General Medical Services Committee, which had agreed the deal with the Secretary of State.
The representatives of the local medical committees then insisted that a referendum was held of all general practitioners. I assume that they would have had to insist on that, whatever decision the majority had taken. Had the numbers been reversed, would the Secretary of State have said today that the majority was very narrow? Would the Secretary of State have demanded that, as the majority had accepted it, the majority should rule, and that the acceptance should be final and a burden on the rest of the medical practitioners?
When the general practitioners examined the offer which had been agreed by the GMSC negotiators, they disagreed completely with the representations made on acceptance. About 82·1 per cent. of doctors who work in the National Health Service voted and, of those, 24 per cent. voted to accept. There was a massive majority and the more the Secretary of State hurls insults at general practitioners rather than trying to explain the deal, the worse matters will become.
I hope that, as a mere Back-Bench Member, I may have the temerity to offer some advice to the Secretary of State. There are many people whose integrity one can attack. It is difficult to attack an hon. Member's integrity in the House, as it is not allowed, but outside the House, the integrity of Members of Parliament is attacked daily by their constituents; they seem to be fair game. It would be extremely difficult if one was to start to attack the integrity of some of the professional people whom we must regard with respect. In Scotland, we may get away with attacking the legal profession—sometimes that is quite fashionable. We may even get away with attacking ministers of religion, depending on which side of the fence we are on and the company we are keeping at the time.
However, neither in Scotland nor in the whole of Great Britain will one get away with attacking the integrity of doctors working in the National Health Service, who put in extraordinarily long hours on behalf of their patients, who look after the sick and the elderly and who do their best to look after the handicapped, often with services that are stretched to the limit. The public do not need a propaganda exercise to tell them that the doctors are under attack when the Secretary of State goes on television to say that doctors are reaching for their wallets.
The elderly in particular depend on their general practitioners, often in the middle of the night, when they are under stress and when there are epidemics of flu, for example. Elderly people feel passionately strongly for those who give them such good service, and they appreciate the kindness when they are under severe stress. I am afraid that on this occasion, as on other occasions, the Secretary of State has made a severe gaffe. He would do better to try to resolve the position by getting the general practitioners round the table to start afresh, if necessary.
As long ago as 1985, the general practitioners in the British Medical Association were seeking meetings with the Secretary of State on negotiations for a new contract. If such negotiations were resumed, if the Secretary of State took into consideration the genuine feelings of members of the public who, from the responses to our review, are

almost 100 per cent. in support not only of the National Health Service, but of those who work in it, and if we tried to use the money that we have to inject more cash into the National Health Service, and use and monitor it properly, instead of trying to make the National Health Service cheaper—to make those who work at the Cinderella end of the National Health Service pay the price for the money that has to be saved to buy equipment that should have been provided anyway—I shall believe that we are making the real progress that people demand and will demand through the ballot box at the next election.

Mr. John Greenway: It is worth stressing that the Government's record on the National Health Service and their proposals for the future of that service are arguably the most misrepresented feature of their policy. Over the past 10 years, we have seen resources increase by 40 per cent. in real terms. Organisation for Economic Co-operation and Development figures now show that we are talking of 6·1 per cent. of gross domestic product spent on health care, as opposed to 5·3 per cent. 10 years ago. That is a tribute to the efforts the Government have made.
I am sorry to see that the hon. Member for Livingston (Mr. Cook) has left the Chamber. He alone is responsible for the most blatant misrepresentation of the Government's reforms. Even before the White Paper was published, he said that there were plans for hospitals to opt out of the NHS. There are no such plans. I see in the longer term—perhaps a decade and a half—a system in which there will be commissioning agents and bodies providing the service on a self-governing basis, whether hospitals or community services.
The Opposition motion seeks to exploit last week's vote by GPs to reject the contract agreed on 4 May between my right hon. and learned Friend the Secretary of State and the General Medical Services Committee. I must declare a personal interest in the matter in the sense that, as my hon. Friends are aware, the chairman of the General Medical Services Committee, Dr. Michael Wilson, is my own GP and a personal friend. I have had opportunities to discuss the matter with him on a number of occasions to a greater extent than one would normally expect as a Back-Bench Conservative Member.
I am pleased that my right hon. and learned Friend referred to the negotiations which took place in the weeks leading up to 4 May and the events of 4 May. There is no doubt that a fair and reasonable compromise was reached in those negotiations. My right hon. and learned Friend will accept that the many representations from hon. Members of all parties about features of the first version of the contract were helpful, especially in relation to rural practice payments, part-time allowances and targets for screening and immunisation.
I was interested to hear my right hon. and learned Friend's remark about yesterday's discussion, from which some believe that all the contract is up for renegotiation. Clearly, that is not possible. If I heard my right hon. and learned Friend correctly, he said that if there were some specific details in the contract on which further discussion might be appropriate, we should enter into further negotiations on them. However, there can be only a few. I have asked the chairman of the GMSC to let me and colleagues know whether there are any particular points that they feel are still a problem. I say that because I do not


believe that it does either side of the argument any benefit to perpetuate a war of words. We now need constructive proposals for the future of the Health Service, and we must take the White Paper proposals forward as quickly as we can.
Conservative Members have had many letters that reflect the misinformation and misrepresentation that abounds about the White Paper. I received one letter from a lady who said:
I have been told by a visitor that when the new NHS starts, my GP will have a limited amount of money to spend on his patients. Because of this, when the money runs out, he will not be able to pay the District Nurses.
Fortunately, I was able quickly to send her a reply from the district general manager of the York health authority, in which he said that he could reassure the lady
completely that there will be no risk, whatsoever, of reducing our District Nursing Service … there are plans for a substantial increase in the number of nurses and physiotherapists and occupational therapists.
It goes on to say that there is every sign that the district health authorities would be able to increase community services because, in the world which the White Paper envisages, they
will have much more time to focus on determining what the public actually want and will get hold of the purse strings so as to be able to ensure that they get it.
At the 1922 Committee meeting last week, the Prime Minister stated a clear objective that we would want to see—namely, a National Health Service that is so good that people will not want private treatment. That is an objective for the future. Nevertheless, yet again it shows the Government's clear commitment to improving the NHS for the benefit of patients. In those circumstances, in trying to help doctors and their representatives to achieve the best for the NHS, Conservative Members have a right to ask them to reconsider whether the slogan of their current campaign, "SOS for the NHS", is appropriate. There is a meeting going on in York tonight under that very banner. It is sad that misrepresentations that will create yet more fear and anxiety in the minds of vulnerable patients are still being perpetuated, despite the comments of my right hon. Friend the Prime Minister.
We need a constructive debate. Patients are rightly asked what difference the White Paper proposals would make for them. District health authorities will have a much stronger brief to find out from patients what they consider should be provided, rather than rely entirely on staff saying what they think they should have. In the York health authority area, several changes are to be implemented over the next two years, taking very much the same stance as the White Paper, to improve the Health Service, make it more responsive to patients, and cut waiting lists. That would inevitably mean changes for the staff. Perhaps one can begin to understand why some staff elements are opposed to further development towards a more flexible response.
Flexibility is one of the key strengths of the White Paper. It is not prescriptive. It provides freedom to develop the service that a regional health authority considers best for its region. Only today I spoke to the chairman of Yorkshire regional health authority, and it is his view that we in Yorkshire can develop the kind of service that we believe is best for Yorkshire. That is because the White Paper offers opportunities. As I have already said, it is not prescriptive.
In their misrepresentation of the Government's proposals, the Opposition have attempted to give the

impression that the changes in the White Paper will be steamrollered through. That is not the case. The more one discusses these plans with district and regional health authorities and with FPCs, the more it becomes clear that they are long-term reforms. The implementation of the proposals will take time. It is clear also that, initially, it 'will be largely experimental.

Ms. Harriet Harman: Will the hon. Gentleman support people in Yorkshire who want a say before any of their hospitals become self-governing NHS hospital trusts and opt out of the district health authority?

Mr. Greenway: They are not going to opt out of the district health authority. As I understand it from the working papers that have been issued, the district health authority will still have power to decide where contracts are placed.

Mr. McCartney: Is the answer no?

Mr. Greenway: The answer is that, until there are proposals for a certain hospital to take self-governing status, nobody knows what the consultation requirements will be.

Mr. Hayes: Is my hon. Friend saying that it is ridiculous to have ballots either in a hospital or the community at large and that, perhaps, the proper focus of attention, as happens now when a hospital opens or closes, is through a community health council?

Mr. Greenway: There will be improved opportunities for CHCs when health authorities are slimmed down in the way the White Paper proposes. If there were any kind of ballot, referendum, or public opinion test about the White Paper proposals, it would be difficult to see how the public could express a clear view, given the degree of misrepresentation about the White Paper proposals.

Mr. Archie Kirkwood: Will the hon. Gentleman give way?

Mr. Greenway: I will not give way. I must get on, as other hon. Members wish to speak.
It is difficult to reconcile hon. Members' arguments on radio and television that the Government are steamrolling through the White Paper proposals, when every serious major structural change will be voluntary. Following my right hon. and learned Friend's statement two weeks ago about community care—we are to implement by April 1991 a positive and absolute change, when local social services departments will have responsibility for community care—we are accused of prevarication and delay. It will not be too many weeks or months before some social services directors begin to think that perhaps 1991 is too soon. Clearly, people will argue for or against the While Paper according to how it suits their political persuasions. I am much more concerned that we should now advance the proposals and take the next necessary steps to put the much-needed and imaginative reforms into place.
Task forces will have to be set up by regions to examine the opportunity for each hospital that has expressed an interest in self-governing status. From my discussions about what might happen in our area in Yorkshire, it is clear that consultants, district general managers and their management teams want more information. I understand that an additional working paper will be issued shortly. I should be most grateful if my hon. Friend the Minister of


State would refer to the timetable that he envisages. We need to know how the trust will increase choice, which hospitals may want to be self-governing, how the management of self-governing hospitals will work, and what discussions about contract details must take place with the district health authorities.
In other words, before any hospital becomes self-governing, we need to establish whether a proposed self-governing hospital can deliver something that improves the current arrangements. In answer to the hon. Member for Peckham (Ms. Harman), when we have got that far and we can publicise those arrangements, the public will have a much clearer impression of what is proposed.

Mr. Kirkwood: Does the hon. Gentleman recommend opting out?

Mr. Greenway: What I recommend will depend entirely on what is proposed. There is a community hospital in my constituency to which I referred my right hon. and learned Friend during Question Time several weeks ago——

Mr. Kirkwood: Is the Secretary of State going to close it?

Mr. Greenway: No, he is not going to close it. That hospital has expressed an interest in self-government. The doctors concerned have expressed a clear interest in having their own practice budget, combined with self-governing status for the community hospital. The Yorkshire regional health authority chairman and the family practitioner committee clerk have expressed the view that that is an exciting prospect.
In answer to the point by the hon. Member for Peckham, it is too early to tell whether that proposal can become a reality for that hospital. We need the information that I have mentioned, and we need to look at each case. That is why I am asking my hon. Friend the Minister of State to tell the House what further proposals there are for the additional working papers.

Ms. Harman: The hon. Gentleman misunderstands my question. I did not ask whether he would recommend that a hospital in his constituency should become self-governing. I asked whether he would recommend that people in his constituency should have a say in whether that hospital becomes self-governing.

Mr. Greenway: The Friends of Malton Hospital is an active association which, I am sure, would want to test local opinion on opting out. My right hon. and learned Friend the Secretary of State has made it clear that any hospital that wishes to become self-governing must provide clear information on whether that will be to the benefit of the patients. There will have to be a proper management structure. At this stage, it is not valid to ask people about their reactions to the proposals when the necessary additional information is not available.
Once the contract for GPs is settled, health authorities will need to encourage their bigger practices to adopt a budget. My impression is that GPs are aware that they will face a choice between adopting a budget and being left behind. By voting against the contract last week, they have perpetuated the confusion about the contract and the

White Paper. It is difficult not to conclude that the confusion of the two issues is a delaying tactic by some members of the medical profession.
It must be recognised that some elements of the Government's plans require more detailed explanation. That is especially so for indicative drug budgets. Initially, they will need to be very indicative if the reassurance that patients will not go without medicine and appliances is to be honoured. We must also take care not to discourage pharmaceutical research. Nevertheless, one question about drug budgets needs to be asked: why the Government are aiming to curb the worst excesses of drugs spending only by GPs and not by hospitals. The answer, of course, is that hospitals already have proper arrangements for generic prescribing to curb spending.
When the proposals in the White Paper are in place, there will be an opportunity for regional health authorities to hold the budget for drugs. That will create the opportunity for bulk purchasing. Will such opportunities be exploited? What purchasing role is envisaged for regional pharmaceutical officers appointed by regional health authorities? Surely their role should include ensuring value for money for regional health authorities as well as protecting the pharmacists.
There was some discussion earlier about how to square the circle between the Government's desire to introduce tax relief or private medical insurance for pensioners with the stated objective of my right hon. Friend the Prime Minister, to which I have already referred. Opposition Members may be interested—I can obtain copies for them if they are—in Post Magazine The Insurance Weekly last week, which published a series of articles about the future of private medical insurance. One article deals with the reasons why some people prefer private medical care. It states:
Why do people choose to go for private treatment when there is a free National Health Service? Market research indicates the reasons are that they can enter hospital quickly and they can choose their admission date, and thus avoid holidays and particular business commitments. They have a choice of which hospital they wish to be treated in, and they can choose their specialist when there is no choice on the NHS. They can have a single room with telephone and their own bathroom and there are flexible visiting hours for family, colleagues and friends.
It then states—this is the key point:
The NHS is making improvements as private hospitals have demonstrated how the patient environment can be improved.
Putting the patient first, as the White Paper states, is the purpose of the reforms.
I welcome the opportunity that the House has been given to debate these matters tonight. However, in securing this debate, the Opposition have scored something of an own goal. The vote against the contract last week was a sad embarrassment for the General Medical Services Committee, not for the Government. As my right hon. and learned Friend said, if he is forced to impose a contract, it will be the contract agreed to by the GMSC.

Mr. Archy Kirkwood: The hon. Member for Ryedale (Mr. Greenway) made an interesting speech, although he looked very uncomfortable throughout most of it, especially when he was referring to the potential closure or opting-out of hospitals in his area.
I understood the hon. Gentleman to say that he was in favour of the Secretary of State renegotiating certain aspects of the proposed GP contract. I agree with that. He referred to his distinguished constituent Dr. Wilson, chairman of the General Medical Services Committee, who negotiated the contract that was so resoundingly rejected in the ballot. I am sure that Dr. Wilson conducted his negotiations in good faith and that he recommended the deal to GPs only because he thought that he could not get the Secretary of State to move an inch further. It remains to be seen whether he is right, but certainly the Secretary of State appears to be setting his face against any further movement—despite the advice of the hon. Member for Ryedale.
It is silly nonsense for good and useful hospitals such as Malton. in the hon. Gentleman's constituency, to consider opting out jus t to preserve their existence. I am sure that Dr. Wilson would agree that it would be better to turn it into a community hospital, run by GPs, to serve the local community.
I do not agree with the hon. Gentleman that the Opposition have shot themselves in the foot. The debate is both timely and important because of the result of the GPs' ballot last week. I shall concentrate my brief remarks on that. More than anything else, the profession is suffering from the Secretary of State's adopted attitude during the negotiations. I for one was surprised by the size of the vote to reject the proposed contract. It might, however, have been different had the right hon. and learned Gentleman been a little more conciliatory during the negotiations. He used insults when GPs needed answers; he used threats when he should have negotiated. He lost the argument not only because of the detail but because of his hostility to people's genuine concerns. It would be a major breakthrough if he accepted that doctors and patients have genuine concerns that need to be dealt with rather than sneered at.
The proposed contract is not entirely about pay and conditions of service; it goes much wider. It embraces the whole future of the development of primary care. I profoundly reject the Government's view that the row is simply one about how much income GPs will receive in the future. I object to the Secretary of State writing letters to Members of Parliament which include sentences such as:
The current argument over the GPs' contract which is often confused with the White Paper arises from contract negotiations involving doctors' salaries.
A great deal of the argument is about the future of primary care—and, for rural areas, the very existence of primary health care. The Government are attempting to switch the focus of the argument and make pay the issue, so that they can use salaries as a weapon to cut costs and to impose their vision of a market-led NHS.
Doctors would respond positively to a new and radically different contract. They are not interested only in pay and conditions. As evidence of that, as far back as 1985, the eminent Dr. Wilson wrote to the Department expressing his disappointment at the speed of progress on the contract. At that time he called for the development of
a comprehensive system of paediatric surveillance, by extending the cervical screening programmes and by encouraging GPs to undertake minor surgery for their NHS patients.
In that letter, Dr. Wilson outlined other proposals, including reducing the maximum list size, improving incentives to appoint additional partners to practices,

encouraging the development of GP community hospitals such as the one in Malton under threat of closure. ending arbitrary restrictions on patient choice——

Mr. John Greenway: Will the hon. Gentleman accept from me that the chairmen of Scarborough health authority and Yorkshire regional health authority have categorically stated that Malton community hospital is not under threat of closure? There is only a review of the services of the peripheral units within Scarborough district. The hospital is not under threat of closure.

Mr. Kirkwood: I accept that. It is always dangerous to stray into another Member's constituency issues. I shall only say, in Mr. Asquith's famous words, that we should all just wait and see.
In 1985, Dr. Wilson was in the business of trying to promote some of the very matters that arise in the current draft contract. The list that he sent to the Government also included improving services in isolated rural communities. Those proposals could have been the basis of an exciting new and agreed blueprint for the future of primary care. Instead, because of the Government's ineptitude in handling negotiations, the contract will mean that GPs will spend less time with individual patients and less time on preventive medicine and health promotion. It will be extremely difficult to make the contract work in rural areas at all.
My constituency is a rural area and no one there is in favour of using competition as a way of improving primary care in rural areas. The Government's disinterest in the development of primary care is illustrated on the first page of the proposed contract document, where it says that central to the Government's plan for improving general medical services is
increasing competition between the providers of the services.
None of my constituents who have heard of that new proposal believes that competition is central to his other hopes for the development of primary health care in the NHS. The existence of facilities is the crucial factor. There are few practices within easy reach of my constituents or competing hospitals to which they can turn. I do not see how the new proposals sit easily with the provision of primary care in rural areas.
That applies in particular to how the proposals will tend to increase list sizes. Two years ago, when the original White Paper on primary care "Promoting Better Health" was published, we warned that establishing a direct link between the number of patients on a GP's list and GPs' remuneration would have severe consequences in rural areas. Since then, the position has been made worse. There is now much more emphasis on the income available to GPs in rural areas being related to the size of their lists.
In my constituency, the proportion of total income derived by GPs is in the region of 27 per cent. and the contract that we are debating takes that to 60 per cent.—55 per cent. plus marginal changes. That will have a catastrophic effect on income. I understand that the rural practice allowances are still under consideration and that the so-called tartan contract has been extended to cover other parts of the United Kingdom. But we cannot escape the fundamental problem in rural areas in Scotland that general practitioners currently receive 27 per cent. of their income from capitation fees; but under the new scheme that will be at least 55 per cent.

The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman): Rural practice allowances are still being discussed. There has been no decision. We recognise and understand the pressures on rural practice in England, and an announcement will be made in due course.

Mr. Kirkwood: I am deeply concerned about rural practice in England, but I also have more than a passing interest in rural practice in Scotland. I accept that the Government made a concession, and I said that it was welcome at the time, but the effect in Scotland will be dire. Some practices face a massive loss in income and may go out of business. That will lead to doctors retiring early and to some practices not taking on new partners or waiting a year or two before deciding to do so. I accept that in wealthy areas some practices will have the means to attract entirely new patients; that is what the Government are trying to achieve.
Let me deal now with the effect of increased list sizes on prevention. Average list sizes will inevitably increase because of the fall in the number of GPs for the reasons that I have just explained. Within that average size there will be stark changes that will tend to act to the detriment of patients. Doctors will have less time with individual patients and less time for time-consuming preventive medicine and health promotion. Nor will there be time for doctors to visit factories and schools or to take the health promotion message to those areas which are missing out. If the increase in the link between pay and the number of patients is not designed to increase list sizes, what do the Government think they are doing increasing the capitation income?
I welcome the fact that, as the Minister said, the system of rural practice payments, is set to continue in England and Wales. We hope that that is true. They were properly taken out of the negotiations and, as I said at the time, we welcome that. However, will the Minister confirm that so far there has been no decision to impose changes to the rural practices payments and that he will continue to consult? Even if there are no other negotiations on the contract details, which the Secretary of State seems to be saying is the case, will discussions at least continue on that aspect of the rural practices payments scheme?
What other important areas will be changed by the draft regulations on rural areas that the Minister discussed with the doctors? There is great concern. I cannot believe that he does not know that already. People such as Dr. Farrow, the chairman of the rural practices committee of the General Medical Services Committee, described the original proposals as
a devious blow and would probably result in the rape of the rural practice.
Dr. John Ball, the chairman of the general medical committee, a Government-appointed committee, said recently that even if rural practice payments continue in their present form, the new proposals would mean that half the English and Welsh practices that have fewer than 1,500 patients will not survive. In Scotland, where list sizes are lower, 25 per cent. of practices would not survive. Those are the sort of terms that we are talking of.
Finally, let me deal with the unrealistic nature of target payments that are being proposed. The Borders area health board has achieved 92 per cent. immunisation. It has always given proper priority to achieving a high immunisation rate, which is in the interests of everyone. However, the Government system of performance-related

pay is causing concern further south. The current targets for screening and immunisation remain unrealistic, and will be made more so because of the extra time spent dealing with the bureaucracy inherent in the contract. The systems of paediatric and geriatric surveillance that the contract stipulates are time-consuming and will produce very little reward in return for a high degree of effort.
The Government's system, even in its modified form, will not work. It will be difficult to decide on the base number of patients. FPC and general practitioners' lists rarely agree because of the lists' ever-changing nature. GPs in deprived areas will be penalised because the migratory population that they serve will make it difficult to trace target groups, and even then they must be convinced of the need for screening and other provisions. Cultural differences mean that many women are anyway reluctant to undergo smear testing.
There is also a need for exclusions from immunisation. I refer to whooping cough and the pertussis vaccination that is the subject of medical controversy of which the Minister is surely aware. A number of patients have medical histories that prohibit them from receiving vaccinations against whooping cough, and they should be excluded from any calculation of a general practitioner's vaccination target. Evidently I did not explain that point very clearly, because the Minister's brow is furrowed. Nevertheless the Government's system of target payments for cervical screening and immunisation schemes are unrealistic.
The Secretary of State must return to the conference table to renegotiate the terms of the new contract. It- he does not, it will be the first contract in history that has not been implemented by agreement, and we shall move into a period of non-co-operation by general practitioners that will not be in the interests of the Government, doctors or patients. Certainly it will not be in the interests of people living in rural areas. I hope that the Government will properly consider all those matters when giving the right hon. and learned Gentleman future instructions as to whether to continue negotiating with the General Medical Services Council.

Mr. Jerry Hayes: The hon. Member for Roxburgh and Berwickshire (Mr. Kirkwood) says that the Government should return to the negotiating table. The truth is that the Government reached an agreement with the General Medical Services Council and British Medical Association negotiators that was welcomed by Dr. Michael Wilson and recommended for acceptance by the BMA's membership in true trade union style. The trouble is that, in true trade union style, Dr. Wilson and the BMA so whipped up the blood of the association's members that they rejected the agreement. Only a few weeks after sensible negotiations, and after sensible concessions were made by Ministers, the BMA said, "This sort of agreement comes from the jaws of Hades," and the doctors became upset.
The hon. Member for Livingston (Mr. Cook) was right, for once, to bring to the attention of the House the serious difficulties facing the Health Service, particularly in respect of waiting lists. It may be helpful if I quote the BMA's chairman on that issue:
The sum of human misery represented by those record figures is a scandal without parallel in any technically developed country.


I am certain that the hon. Member for Livingston and his right hon. and hon. Friends agree with that sentiment, as will the rest of the House. But it was expressed by Dr. James Cameron, chairman of the BMA, in 1978. Nothing changes very much. Lord Donoughue, writing in his memoirs about Labour Government cuts—I do not want to go too much into old history—commented:
It was the usual rag bag of random cuts in public investment … cuts in education, the National Health and public industry investment were imposed in full … Half the cuts were in capital investment.
I shall offer one more quotation from the past:
I do not believe that the problem
of soaring waiting lists
would be solved by any means by simply holding on to a large number of small, uneconomic hospitals."—[Official Report, 10 May 1977; Vol. 931, c. 1087.]
One can imagine what the response of the hon. Member for Livingston and his right hon. and hon. Friends would be if that remark had been made by my right hon. and learned Friend the Secretary of State, or by my hon. and learned Friend the Minister. In fact, that statement was made by the then Labour Secretary of State for Social Services, David Ennals.
What has changed, however, is the amount of money that is pumped into the Health Service. I do not necessarily agree with the argument that relates such expenditure to gross domestic product, but it is used from time to time. When the right hon. Member for Plymouth, Devonport (Dr. Owen), who is not now in the Chamber, was Health Minister in the halycon days of the Wilson Government, that Government were spending 4·8 per cent. of GDP on health. In the days of David Ennals and the Callaghan Government, the figure was 5·3 per cent. Now, in the wicked days of the Thatcher junta, we are spending 6·1 per cent., and that does not include private health care. Nor does it take into account the fact that the economy is positively booming, and not on the rocks as it was in the days of the last Labour Government.
The trouble is that none of us knows where the money is going. We do not know the cost of treatment and operations, and if we do not know that, how on earth can we plan for the future? That is the essence of the reforms in the White Paper, and what we should be discussing this evening.
It is probably the exception to the rule, but I have read the motion very carefully. It has all the balance of a wet blancmange. At one moment the hon. Member for Livingston (Mr. Cook) wobbles on the subject of the Prime Minister; at another he wobbles on private health insurance. Not so long ago, it was easy for the hon. Gentleman to have a crack at the Prime Minister for using private health care. The fact is that we have a democracy, and people have the right to choose: that is the basis of Government policy, although the hon. Gentleman disagrees with it. My right hon. Friend the Prime Minister has done something very important in stating publicly that the Government's aim is to make the Health Service so good that people will neither want nor need to use private medicine. As the hon. Gentleman said, they use it now to jump queues. The White Paper proposals will stop the queues forming in the first place.
I cannot understand the Opposition's paranoia about private practice. I could understand that paranoia if the Government were proposing a Health Service that was not free at the point of delivery; I could understand it if they were proposing a Health Service that would not be funded

primarily from taxation. Those, however, are the major principles behind the proposed reforms, as is made categorically clear.
The West Essex health authority, in my constituency, has one of the 22 longest waiting lists in the country. My people are waiting two years for hernia operations.

Mr. McCartney: That is how a Tory Government treat them.

Mr. Hayes: I do not consider it right or fair that my constituents should have to wait two years for a hip or cataract operation, when the health authority could have the opportunity of giving the patient the choice of going a little further up the road and having the operation done privately—provided that the patient does not have to pay for it and the health authority does not have to provide any more money. That strikes me as absolute common sense. We are proposing to allow people choice and the chance of having their pain and suffering removed quickly.
Judging by what we see on television and in the newspapers, hear on the radio and, indeed, hear from Opposition Members, one would think that the medical profession was 100 per cent. against the proposals. But those of us who go around the country speaking to the presidents of the royal colleges, to general practitioners and to hospital consultants can tell Opposition Members that those people—including the British Medical Association and the Joint Consultative Council—are in favour of medical audit. They have been pushing for it for years. They are also in favour of resource management: many of them have been pushing for that for years. They are in favour of money travelling with the patient, because they know that it will lead to the abolition of the efficiency trap.
Without those three fundamental foundation stones of policy, there will not be self-governing hospitals or GPs' voluntary practice budgets. If self-governing hospitals are as wicked as some people say, people will not want to take up the proposal. If voluntary budgets are as hopeless as some people say, GPs will not put their names in for them. It is a matter of choice. There is agreement about the fundamental reforms of medical audit, money travelling with the patient and resource management, and as the Secretary of State said earlier, those constitute 80 per cent. of the proposals.
I was bemused by something said about the GPs' contract. Many hon. Members have talked to a large number of GPs over the past few weeks. Anyone who has read the letter from Dr. Michael Wilson will see that they are in favour of the main thrust of the contract and have been pushing for many of the major proposals of the contract for a number of years. However, I am saddened when GPs tell me that they cannot see the point of visiting someone over the age of 75. They say that it is a waste of time. I cannot understand GPs who ask why on earth they should bother about screening when it simply means that they will find more things wrong with the patient. I cannot understand GPs who ask why they should have to immunise in the way the Government say, even though our figures are well below what the World Health Organisation advocates. That is absolutely wrong.
The Opposition were right to have some doubts about private medical insurance. However, they could have had more doubts if the Government were planning to offer overall tax relief for private medicine. That would be


totally wrong because it would withdraw a great deal of funding from the Health Service. That is not the case. The Government are trying to help the elderly, many of whom may have been trade unionists, who had many options open to them through their companies and who find as soon as they retire that those options stop. It is all a matter of choice.
I am not criticising the hon. Member for Peckham (Ms. Harman), but when she goes home tonight she will go back to a nanny. There is nothing wrong with the hon. Lady having a nanny to look after her children. She does not receive tax relief for it, although some say that she should. She is probably not satisfied with the sort of cover available to her children in the community. However, it is her choice. There is not a great Labour party campaign against nannies and there is not a whacking great trade union of nannies which pays the Labour party. Therefore, it is hypocritical for the Labour party to criticise the Government's proposals in this way.
I have read the motion carefully. I hope that the hon. Members for Livingston and for Peckham will look carefully at the first line and welcome with enthusiasm the Prime Minister's pledge and support what she has been saying, as it is a laudable aim.

Mr. Ian McCartney: Having listened to the hon. Member for Harlow (Mr. Hayes), I have decided to tear up my original speech. The hon. Gentleman and I have one thing in common—we are both members of the Select Committee on Social Services, which has considered the review being proposed by the Government. Its final report will be produced on 10 August. I am rightly bound by the rules of the House not to discuss its contents, although they have been widely discussed in The Independent, The Guardian and other newspapers.
Whatever the recommendations of the Committee, its members—including many Conservative Members—were influenced by the evidence received through cross-examination, personal interview and other means when considering carefully the Government's proposals. Throughout the Committee's investigations, the attitude of the Secretary of State, which he displayed today, was sometimes foolish and sometimes insulting. With one exception, he displayed the same attitude to and perceptions about the working role of the Committee, despite the attempts of its members to try to tease out of him the Government's intentions for implementing their proposals.
The hon. Member for Harlow is a barrister. He proved tonight that if a barrister is given a brief he will argue that black is white. On 24 May, the Committee produced an interim report based on evidence received and the cross-examination of the Secretary of State and his senior officials. The hon. Member for Harlow signed that report. Time will not allow me to go through all the report's conclusions, so I shall read only two with which the hon. Member for Harlow agreed. The report says:
'''A programme of persistent improvement … will provide a more effective way forward for the National Health Service than the search for a radical reconstruction of the service.'
The hon. Member for Harlow agreed with the report's final conclusion, which says:

If the Government's proposed timetable for introducing the vastly greater changes to the health service proposed in the White Paper is adhered to, we have serious fears that the stability of services and continuity of patient care may suffer during the years of transition to a new, untested system. As we said in our Report last year:
'the strengths of the NHS should not be cast aside in a short-term effort to remedy some of its weaknesses'.
That remains our considered view.
That was the considered view of the hon. Member for Harlow on 24 May. I am saying not that he is trying to bring his profession into disrepute, but that in the white heat of argument this evening——

Mr. Hayes: Will the hon. Gentleman give way?

Mr. McCartney: I will give way in a minute.
The hon. Gentleman is trying to protect the Government, which is an honourable intention for a Conservative Member, but he is suffering from amnesia about the evidence that he assisted in taking, which he supported only a few weeks ago.

Mr. Hayes: The hon. Gentleman should read the report carefully. Although I am unable to talk about the report until 10 August, a minority report will be produced in due course. Everything with which I agreed in the report is a matter of public record. I have never said that I wholeheartedly agree with the Government's timetable. The part of the report to which the hon. Gentleman referred was written after we had heard from the Secretary of State. As will be apparent from the next report, the Secretary of State made it clear that the projects will be pilot projects in all but name. He further said that they would be evolved and run in, which satisfied me, and I hope will satisfy the hon. Gentleman. I should be grateful if he did not misrepresent the work of a respectable Committee.

Mr. McCartney: Far be it from me, a member of the Committee, to misrepresent it. I fear that, following the example of many barristers in tight corners, the hon. Gentleman is wriggling. The report in question was produced and voted on after interviews with the Secretary of State, accompanied by officials of his Department, on two occasions.

Mr. Hayes: It was written before that.

Mr. McCartney: I have made my point, and the hon. Gentleman will have to be content to allow history to determine whether my or his version is more acceptable to the nation—if indeed the nation decides to take note of what either of us has said.
Rather than being acceptable to the communities covered by the district health authorities, the review is provoking panic in many areas. For example, I have in my area the Wigan health authority, one of the largest metropolitan areas in Britain in terms of population and geographical size, with four parliamentary constituencies. It contains a number of district hospitals.
That authority has reached the interim conclusion not to support the concept of opting out, but it is fearful that competition will mean that the district hospitals will not be able to compete in the ever-increasing scramble for resources. The health authority takes the view that resources have been cut consistently every year by the Conservatives through the north-west regional authorities and through political appointments such as the chairmen of the region and district health authorities.
In other words, the district health authority's political chairman and the politically appointed district general manager have come up with a radical new idea following the decision not to opt out. Their idea is to close all our district general hospitals. Their proposal would asset-strip and sell off the land to whatever speculator would like to purchase Whelley, Billinge, Atherleigh and Astley hospitals and the Royal Albert Edward infirmary in Wigan. Their argument for asset-stripping such a large organisation of its district resources is to amalgamate them into one component.
Within the last 48 hours, on the ground of an emergency financial crisis, it has been decided to close one of our hospitals which cares for the mentally confused elderly and people suffering from senile dementia. Because it is claimed that an emergency exists, it is proposed not to consult the community health council, the patients' representatives or the patients' relatives.
I understand that, perhaps even this evening, those patients are being moved out into the private sector. The community health team, the social services and those involved in the care of the people in that hospital have not been consulted about the adequacy or otherwise of the alternative arrangements in the private sector. Astley hospital is to close following an announcement in recent days.
A few months ago, a Minister came to Wigan to make a triumphant speech about the local Royal Albert Edward infirmary, stating that that hospital was safe in the Government's hands and that a multi-million-pound development project would go ahead. On that occasion, my hon. Friend the Member for Wigan (Mr. Stott) and I stood outside in the rain trying to make the point that a scheme was afoot to close that hospital. That was greeted with denials. Last week the health authority, in closed session, was informed that the Wigan Royal Albert Edward infirmary was indeed to close.
Assurances were given by the regional chairman, and even by the Department, that new developments taking place at Wigan infirmary would continue. We were assured that it would have a place in the 1990s as a modern district general hospital. Last week, the authority was informed that it was to close.
Not three years ago, the Department said that Billinge hospital would be developed in the 1990s on a district basis with the latest maternity facilities. We were also assured that it would have facilities for the short-term care of the mentally ill. On that basis, we agreed to the closure of a nursing facility in Leigh. That was closed and sold off for a housing development.
It was announced that weekend facilities at Billinge maternity hospital would close, and there is a long-term proposal that the maternity unit at Billinge hospital will close completely. It does not service just the Wigan health area, but also parts of the St. Helens and Knowsley health authority area, which are two of the most socially and economically deprived areas in the north-west region, which is one of the most socially deprived regions in the United Kingdom.
The facilities for the mentally confused at Billinge hospital are so overstretched that Wigan borough council social services department is having to retain patients who would, under normal conditions, be contained in the units at Billinge and at other facilities at the Leigh end of the authority. Because of the cash crisis, the social services department is having to take on the nursing requirements

of the mentally confused and the elderly ambulant, in growing numbers. That is the reality of, and the background to, the Government's proposals.
Not one part of the Government's proposals has shown that there will be any new financial resources available to my authority. What is happening, in advance of the proposals, is an asset-stripping job on a grand scale. Public assets worth hundreds of millions of pounds will he sold, and not one local person will be asked if they would like Wigan hospital, Billinge hospital, Leigh infirmary, Atterleigh hospital and Astley hospital to remain open.
None of us is in the ball game of keeping open hospitals that need to be closed if alternatives are provided, but we are opposed to the naked opportunism of those politically motivated people in the Health Service—people who have been appointed by Conservative Members and Conservative party members—who are asset-stripping on their behalf in advance of the Health Service reviews.
I ask the Secretary of State—with whom I have clashed several times—to institute an immediate inquiry into why Wigan health authority, on the grounds of an emergency. is taking patients out of hospitals and dumping them into the private sector, without any consultation with the social services or with those people who are currently responsible for looking after them. The least that the Secretary of State can do is give them a commitment that he will look into that within the next 24 hours.
I hope that, when the report is produced on 10 August, the Secretary of State will respond effectively to it.

Mrs. Audrey Wise: I have listened with the utmost attention, as my hon. Friend represents a constituency in the north-west, to the catalogue of disasters that are befalling his area. I do not want to compete with him by raising larger issues, as he has done, but I would like to draw my hon. Friend's attention to a small but significant matter which has occurred in my area, which shows the madness caused by the so-called search for efficiency.
Preston district health authority has saved the magnificent sum of £1,500 during the past year by cutting the availability of free incontinence pads for elderly ladies. Whether we look at the large scale, as my hon. Friend has done, or at the small scale, as I have done, the picture is the same.

Mr. McCartney: My hon. Friend is correct. On the day that the former Under-Secretary visited Wigan and salmon sandwiches and a huge banquet were provided in Billinge hospital, babies were being born and the supply of nappies had to be restricted. That shows the Government's priorities.
I hope that the Secretary of State will, after 10 August, take into account the views in the majority report, and that he will assure the public and Opposition Members that he will not ride roughshod over the doctors, the midwives and the nation, who are totally opposed to the proposals.

Mr. Tony Baldry: I hope that the House will understand if, given the short time left in the debate, I do not propose to give way as much as I would like.
I think that hon. Members agree that the ultimate purpose of the National Health Service must be to improve services to patients. The White Paper's proposals will do that by giving doctors and medical staff more


control, by cutting central administration controls, devolving managerial power and by allowing general practitioners to become budget holders and hospitals to become self-governing—all within a framework of a publicly funded Health Service. In that way, patients will come first. The ambition of everyone must be to ensure that each and every patient in the NHS is treated as an individual.
Central to the NHS, as with every publicly funded service, must be money. It is interesting that, during the debate, we have heard little about money. The Opposition's motion must be the first motion on the NHS tabled by the Leader of the Opposition that has not alleged that the NHS is underfunded. That is perhaps because the Opposition have recognised that, whatever funding proposal they put forward, the Government will always more than match it.
Over the past 10 years, the Government have persistently and diligently provided more money for the NHS. In 1978–79 the Health Service budget was £7·75 billion and in 1989–90 it is about £26 billion. National Health Service spending has increased by 36 per cent. more than inflation and has grown more rapidly than the rate of growth of the real economy. Health spending has risen from 4·8 per cent. of GDP 10 years ago to 6·1 per cent. now. If we reverted to the funding of the NHS when the Labour party was in government, we would have to cut the number of doctors and dentists by about 14,000, the number of nurses and midwives by 67,000 and the number of hospital patients by 1·5 million.
Of course, the National Health Service always faces fresh challenges. For example, 70 per cent. of NHS costs are labour costs, and there has been a dramatic and welcome increase in the number of NHS employees over the past 10 years—5,800 more doctors and dentists. Their pay has grown 25 per cent. more than inflation since 1979. Nurses, whose pay fell under Labour—they received increases below the rate of inflation for three years—have seen their pay rise by 45 per cent. more than inflation since 1979.
As well as trying to ensure that doctors and nurses and those working in the NHS are well remunerated, there are also the challenges of an ageing population and of medical advance. In response, the Government will clearly have to provide ever more money for the NHS, but we all have an interest in ensuring that that money is well spent. As my right hon. and learned Friend the Secretary of State has said many times, the NHS is not a business, but clearly it can be more businesslike.
It is right that the Government should devolve greater powers and responsibility to local levels. For far too long, the NHS has been over-administered and under-managed. This has led, for example, to the Public Accounts Committee discovering, according to a report published last year, that in the five districts whose operating theatre usage was studied, only 72 per cent. of available sessions were regularly scheduled for use and of those about 23 per cent. were cancelled, often at short notice. Consequently, only half the daytime operating theatre sessions were used—no wonder we continue to have long waiting lists for cold surgery. The Public Accounts Committee concluded:
Traditional practice and habits, framed for the convenience of consultants and staff must be reviewed as necessary.

Furthermore, all too often the lunatic situation arises that if a hospital does more work it simply runs out of money more quickly. That is a lunatic efficiency trap. The proposed internal market will replace that efficiency trap with a much better system whereby the more contracts that are won to provide services, the more work is done and the more money secured. Hospitals that increase their referrals will also increase their income.
Let us be clear that there is a consensus on the need for an internal market. In a speech a year ago at Guy's hospital, the hon. Member for Livingston (Mr. Cook) said:
Personally, I can see merit in greater flexibility that permits health authorities to convert cross-boundary flows of patients with cross-boundary flows of cash.
That is exactly what the internal market is about—correlating cross-boundary flows of patients with cross-boundary flows of cash.
The right hon.Member for Plymouth, Devonport (Dr. Owen) observed that
bringing the disciplines of the internal market into the NHS is the most important single reform I would advocate, for it can work with the grain of the NHS and not weaken its ethical basis.
As the Prime Minister has made clear, the internal market has nothing to do with privatising health services but everything to do with improving them.
That leads us to the background of the general practitioners' contract and the recent debate. The House should recollect that the GPs' draft contract has had a long gestation period. We have almost forgotten, in the mists of time, the Green Paper "Promoting Health Care—An Agenda", which came out in April 1986. That Green Paper was followed by the White Paper "Promoting Better Health" in November 1987 and that, in turn, led to long negotiations with representatives of the GPs on the detailed proposals.
All hon. Members will have had a letter from Dr. Wilson factually reporting that the general practitioners have voted against accepting that contract. Interestingly, no argument was advanced in that letter to explain why general practitioners had rejected the contract. It would have been very difficult for Dr. Wilson to advance such arguments, because the General Medical Services Committee contract was the very contract that he and the other negotiators had recommended for their own members.
I am looking forward to a happy recess because the general practitioners in Oxfordshire voted in support of the proposed contract.

Mr. Mike Watson: Will the hon. Gentleman give way?

Mr. Baldry: No, there is very little time and I made it clear at the start of my speech that I did not intend to give way. The hon. Gentleman, who was not even present then, can hardly expect to intervene now.
It is difficult for Dr. Wilson and the GMSC to suggest that a contract that they negotiated and agreed is flawed in some way. I have yet to see, and I suspect that other hon. Members have yet to see, any detailed proposals from the GMSC on how the contract should be improved.
The background to the contract is that spending on GP services has risen by 50 per cent. over and above inflation during the past 10 years. The number of GPs in practice is up by 20 per cent. and their support staff are up by 50 per


cent. Despite that, real concerns remain about the present GPs' contract because it does not sufficiently reward zeal or quality and it is not sufficiently sensitive to patients.
It seems to be suggested that by increasing the proportion of doctors' remuneration that comes from capitation, we shall force doctors to take on more patients and undermine the quality of care. The case for making a significant proportion of GPs' income dependent on capitation is not new. That case was made by one of the authors of the National Health Service, Nye Bevan himself, on the founding of the NHS. He said:
I cannot dispense with the principle that the payment of a doctor must in some degree be a reward for zeal, and there must he some degree of punishment for lack of it. Therefore, it is proposed that capitation should remain the main source from which a doctor will obtain his remuneration."—[Official Report, 30 April 1946; Vol. 42, c. 55.]
Nye Bevan saw capitation as one of the underlying principles on which general practitioners should be rewarded. Moreover, nothing in the Government's proposals would increase doctors' average list size. Patients will register with the practice of a doctor who they think gives the right quality of care and the right amount of time. GPs' list sizes are falling from an average 2,200 to under 2,000 now. Just as it is impossible to invent new patients, so it is mathematically impossible to increase the average list size.
I hope that, during the summer, GPs will reflect that the contract that they have been offered is a good one and that many concessions have been made by my right hon. and hon. Friends in the Government, after listening to representations that they undoubtedly received from hon. Members on both sides of the House. While the Government's health proposals will not solve everything, they will make several important advances, extend patient choice, encourage enterprise in hospitals and among GPs and improve the quality of patient care and treatment in the framework of a publicly financed Health Service.

Ms. Harriet Harman: It was evident from the Secretary of State's speech that he did not welcome the debate this afternoon, but he rose to the occasion with his usual combination of trying to distract attention from the real issues and a dose of abuse for the doctors. [Interruption.] Hon. Members who were present will agree that that is a fair description of his speech.
Our main concern about the contract is the incentive that it provides to GPs to increase the number of patients on their lists. Successive Governments have encouraged GPs to reduce the number of patients on their lists. That was for the good reason that, if GPs are to make the correct diagnosis, give appropriate treatment and prescriptions, and manage long-term illnesses properly and sensitively, they require time. Doctors want more time for each patient and patients want more time from their doctor. Yet the Government will make good doctors into bad doctors by paying them to take more patients on to their lists, so that each patient will have less time.
Most people are happy with their GP. A poll in The Daily Telegraph showed that 80 per cent. of people were happy. The 20 per cent. who said that they were not happy said that the doctor always seemed rushed, did not have time to explain and was not interested in them as a person. Increased patient list sizes will increase dissatisfaction with GPs. Studies of what patients want from general practice

consistently show that they want a doctor who listens, understands, takes trouble and is prepared to explain. In other words, they want a doctor who has time for them.
Not only doctors take the view that an increase in the percentage of doctors' pay attributable to capitation will result in increased list sizes. The Patients Association, the Association of Community Health Councils and a range of other voluntary organisations and academic institutions that have no vested interest and no axe to grind believe that that will be the effect. So do organisations such as the Centre for Policy on Aging, Age Concern, the Health Visitors' Association and the National Children's Bureau. The Government are alone in believing that performance relates to the number of patients treated rather than the quality of care.
The Government believe that the Health Service centres on cost rather than on care. That is why they are obsessed with the GPs who refer more than the average number of patients to hospital, but are blithely unconcerned about the GPs who under-refer and whose patients suffer because they are not referred to hospital.
The Government are obsessed, too, with GPs who prescribe more than the average for their patients, but they are blithely unconcerned about patients who suffer because their GPs under-prescribe. They are not concerned with the appropriateness of the referral or the prescription; all they are concerned about is the cost. Their real interest is in cash, not care. Their prime concern is a healthy bank balance, not a healthy patient, and the doctors know that.
We have seen what cash limits have done to hospital services and how hospital services have been squeezed. We all know that cash limits will come down on family doctors. The Health and Medicines Act 1988 put in place cash limits on ancillary services for GPs' practices and practice premises. The White Paper plans to cash-limit the rest of GP services—prescriptions and referrals to hospital.
I do not see any shaking of heads, but the Government have up to the present day been denying cash limits on GP services. However, it is clear that they will be cash-limited. I shall use an example that makes it clear that that is what is intended by the White Paper. When a patient goes to the accident and emergency department and is subsequently admitted to hospital, the bill for that treatment will go to the hospital, if it is an opted-out hospital, or to the district health authority. When a patient is referred to hospital and is admitted on the basis of a GP's referral, the GP's practice budget will have to bear the cost of that treatment.
The Government are afraid that GPs faced with a cash-limited budget, who see a patient who needs treatment in hospital, will, instead of referring him to the out-patient department, advise him to go to the accident and emergency department, because then the bill will be paid by the hospital of the district health authority. That is why, in working paper 3, the Government are advising hospitals to have watchdogs in their accident and emergency departments to see whether the hapless patients are real accident or emergency cases or whether they are refugees from cash-limited GP budget holders. That is. clear evidence that GP's practices will be cash-limited. The Government anticipate that GPs will try to escape the cash limit by advising their patients to go to accident and emergency departments rather than referring them to hospitals in the normal way.
The most important difference that the Government have with just about everyone else is the substance of the proposals in the contract and the White Paper. We cannot let the debate pass without a comment on the way in which the Secretary of State has handled the issue. Doctors and the public have disagreed with him. His hon. Friend the Member for Ryedale (Mr. Greenway) said that the public were too thick to be allowed to have a say on the White Paper. On "Any Questions" a couple of weeks ago, when a doctor disagreed with him about the White Paper proposals, all the Secretary of State could do was to rubbish him and to say, "You have not read the White Paper." He has accused GPs of reaching for their wallets. Anyone who disagrees with him is accused of misunderstanding the proposals. Those people who want change other than that which he is proposing are told that they want no change at all.
The problem is that the Government have not been prepared to listen to those people who work in the Health Service, who use the Health Service and who have been crying out for change. That shows not just sluggishness or bullying, although it certainly shows that, but it shows the Government's inability, refusal and unpreparedness to listen to views that do not fit in with their ideological dogma. It is that same authoritarianism that will prevent people from having a say in whether their hospital opts out.
The Prime Minister has said that she will make the Health Service so good that no one will want to use private health care. Nobody believes that, but if that were the case, we should welcome it. However, as the Prime Minister wants competition and market forces in health care, it is clear that that statement has no credibility.
When we return to the House in the autumn, the Government will try to impose the new contract on the doctors, despite a ballot in which there was a vote of three to one against. We are told that there will be no new discussions. We will oppose the Government's attempt to force a contract on the GPs. The Secretary of State will have to fight his contract through. Any time that Conservative Members vote to impose the new contract, that will simply serve to remind their constituents how little they now have in common with their Member of Parliament.
The more the Government berate the doctors, the more they widen the gulf between Government and public opinion because people do not accept that doctors are stupid or greedy. They do not accept that doctors are interested only in their pockets, not in their patients. When Conservative Members return to their constituencies for the recess, they will discover the huge consensus against the Government's proposals. There is literally nowhere in the country where they will find support for the contract or the White Paper. There are no places to which the Government can run with this proposal.
We often hear talk of Tory heartlands, but even the Tory heartlands are opposed to these proposals—to the contract and to the White Paper. There are no Tory heartlands when it comes to the National Health Service. When Conservative Members vote tonight, they will simply be voting to increase the gulf between themselves and the people they are supposed to represent.

The Minister of State, Department of Health (Mr. David Mellor): I begin by thanking my hon. Friends the Members for Ryedale (Mr. Greenway), for Harlow (Mr. Hayes) and for Banbury (Mr. Baldry) for their supportive speeches. My hon. Friends' penetrating speeches have made my task easier. I must advise especially my hon. Friend the Member for Ryedale that I should like to write to him on the specific points that he raised because time is pressing and I want to make other points tonight.
It is clear that the Labour party has cobbled together an end-of-term assault on the Government based on the lowest common denominator of opposition to some of the moves to reform the Health Service. It is interesting that the hon. Member for Peckham (Ms. Harman) laboured so mightily to denounce a contract which, for the first time, offers the better doctors rewards for doing more to treat their patients.
What can be wrong with a contract which, for the first time, introduces basic payments to include opportunistic screening and check-up invitations for the healthy every few years to give us a chance to be a service for health, not just for sickness? What is wrong with a proposal that all newly registered patients should be offered a check-up? What is wrong with a proposal that doctors should be paid a higher capitation payment for having elderly patients on their lists—an argument that is totally distorted by the suggestion that the contract will somehow provide a disincentive to treat the elderly when the opposite is the case?
What is wrong with extra payments for looking after the very young and for immunising them against preventable diseases when our record on immunisation is far too low compared with that of many other countries and leaves a great deal to be desired? What is wrong—I should have thought that this point would be of particular interest to Opposition Members—with extra payments for doctors who practise in deprived areas to try to do something about the inequalities of health standards that so many research projects have shown exist in some inner-city practices and practices elsewhere?
It seems astonishing that, in the cynical cosy-up between the Labour party and the BMA, all those facts should be disregarded while both the hon. Members for Livingston (Mr. Cook) and for Peckham—the Opposition's Front-Bench spokesmen—have done nothing more than parrot the BMA's case. Indeed, that was taken to absurd lengths by the hon. Member for Livingston when he set out to prove that it is not possible to reach targets of 70 per cent. in inner-city areas. Nothing could be further from the truth. It is perfectly possible, as the public health laboratory service study showed in 1985, given proper incentives, for everyone in the country, wherever they live, to have the opportunity, and to take it up, to have their children immunized. It seems extraordinary that Labour Members should share the patronising view that somehow people who live in inner-city areas are less interested in the health care of their children. When places such as Doncaster and Rotherham, which are not exactly bastions of the middle class, can achieve 90 per cent. immunisation rates for polio, why cannot other parts of the country do the same? For the first time, we are giving people an incentive to do that.
As the York university study showed only too clearly, the problem at the moment is that innovative practises sit


alongside those which are practising the medicine of 20 years ago, but there is no difference in the remuneration to the innovative practice. How are we to redress the imbalance in quality between one group of GP practices and another unless we have a contract which, for the first time, rewards good performances? I am astonished that that view cannot be shared on both sides of the Chamber, as all our constituents will gain from the introduction of such a contract.
It is even more astonishing that the Labour party should see fit to put forward the BMA's obstructive arguments against the contract, since whenever any Government have sought to make changes, whether those changes were right or wrong, they have run into difficulties with the BMA.

Mr. Sam Galbraith: That is not true.

Mr. Mellor: The hon. Gentleman says that it is not true, but I shall demonstrate that it is.
In the past 25 years there have been two substantial periods of Labour Government. In the 1964 Parliament it took four months of a Labour Government before the BMA, in February 1965, was advising its members to give three months notice of termination of their contract with the NHS. That is the background against which the contract that we are now replacing was put into place by the Labour Government. In the 1974 Parliament, it took 18 months before the BMA council was condemning what the then Labour Government were doing as unsound and a threat to fundamental freedoms. In 1977 Mr. Anthony Grabbham, now Sir Anthony Grabbham, a spokesman for the BMA then as now, said of Labour's pay policy:
It is a catalogue of broken promises, a cynical disregard of agreement and progressive emasculation of review body procedures all leading to inexorable degradation of consultants' status.
The attempt to suggest a common cause between the BMA and the Labour party is specious, and the mess of potage which Labour Members have sold is the rights of their constituents to a good and consistent policy of health care that modern reforms can bring about.
Once again, we have heard so much from the Opposition, but not a word about a coherent alternative to address the NHS's central problems. The Opposition motion specifically criticises the Prime Minister's words when she set out the aspiration that she wants to see the National Health Service so good that people will not need private medicine. I consider that to be a perfectly estimable aspiration. It provides an interesting contrast with the Labour party. In the 1970s, the Labour party was prepared to drive the Health Service into total disarray to abolish private medicine. Its latest policy document shows that it seems to have learnt very little from that. The problems of the National Health Service, such as the long waiting lists which have caused some people to go private, are not the source of proper analysis by the Labour party, but simply used as a crude stick with which to beat the Government.
In a free society where people must have the right to make private provision out of taxed income if they choose, the best way is to make them feel that they do not need to do that. One way to make people sure that they do not need to do that is to cut waiting times. We have research that shows that if every district health authority was able to use its operating theatres as effectively as the average,

we could get rid of long waiting times overnight. That will come about only if a coherent set of proposals is pursued, which involves not only additional resources for the National Health Service, but a proper and sensible way of ensuring that those resources are set in the right management framework. I hope that the House will reject the Labour party's opportunistic motion tonight.

Question put, That the original words stand part of the Question:——

The House divided: Ayes 207, Noes 315

Division No. 321]
[10 pm


AYES


Adams, Allen (Paisley N)
Ewing, Mrs Margaret (Moray)


Allen, Graham
Fatchett, Derek


Alton, David
Fearn, Ronald


Archer, Rt Hon Peter
Field, Frank (Birkenhead)


Armstrong, Hilary
Fields, Terry (L'pool B G'n)


Ashdown, Rt Hon Paddy
Fisher, Mark


Ashley, Rt Hon Jack
Flannery, Martin


Ashton, Joe
Flynn, Paul


Banks, Tony (Newham NW)
Foot, Rt Hon Michael


Barnes, Harry (Derbyshire NE)
Forsythe, Clifford (Antrim S)


Barnes, Mrs Rosie (Greenwich)
Foster, Derek


Barron, Kevin
Fraser, John


Battle, John
Galbraith, Sam


Beckett, Margaret
Galloway, George


Beggs, Roy
Garrett, John (Norwich South)


Bell, Stuart
George, Bruce


Benn, Rt Hon Tony
Gilbert, Rt Hon Dr John


Bennett, A. F. (D'nt'n &amp; R'dish)
Godman, Dr Norman A.


Bidwell, Sydney
Gordon, Mildred


Blair, Tony
Gould, Bryan


Blunkett, David
Graham, Thomas


Boateng, Paul
Grant, Bernie (Tottenham)


Boyes, Roland
Griffiths, Nigel (Edinburgh S)


Bradley, Keith
Griffiths, Win (Bridgend)


Bray, Dr Jeremy
Grocott, Bruce


Brown, Nicholas (Newcastle E)
Hardy, Peter


Buckley, George J.
Harman, Ms Harriet


Caborn, Richard
Hattersley, Rt Hon Roy


Callaghan, Jim
Heffer, Eric S.


Campbell, Menzies (Fife NE)
Henderson, Doug


Campbell, Ron (Blyth Valley)
Hinchliffe, David


Campbell-Savours, D. N.
Hoey, Ms Kate (Vauxhall)


Canavan, Dennis
Hogg, N. (C'nauld &amp; Kilsyth)


Cartwright, John
Home Robertson, John


Clark, Dr David (S Shields)
Hood, Jimmy


Clarke, Tom (Monklands W)
Howarth, George (Knowsley N)


Clelland, David
Howell, Rt Hon D. (S'heath)


Clwyd, Mrs Ann
Hoyle, Doug


Cohen, Harry
Hughes, John (Coventry NE)


Coleman, Donald
Hughes, Robert (Aberdeen N)


Cook, Frank (Stockton N)
Hughes, Simon (Southwark)


Cook, Robin (Livingston)
Illsley, Eric


Corbett, Robin
Ingram, Adam


Corbyn, Jeremy
Janner, Greville


Cousins, Jim
Jones, Barry (Alyn &amp; Deeside)


Crowther, Stan
Jones, Martyn (Clwyd S W)


Cryer, Bob
Kilfedder, James


Cummings, John
Kinnock, Rt Hon Neil


Cunliffe, Lawrence
Kirkwood, Archy


Cunningham, Dr John
Leadbitter, Ted


Darling, Alistair
Leighton, Ron


Davies, Rt Hon Denzil (Llanelli)
Litherland, Robert


Davies, Ron (Caerphilly)
Livsey, Richard


Davis, Terry (B'ham Hodge H'l)
Lloyd, Tony (Stretford)


Dixon, Don
Lofthouse, Geoffrey


Dobson, Frank
Loyden, Eddie


Doran, Frank
McAllion, John


Douglas, Dick
McAvoy, Thomas


Duffy, A. E. P.
McCartney, Ian


Dunnachie, Jimmy
Macdonald, Calum A.


Dunwoody, Hon Mrs Gwyneth
McKay, Allen (Barnsley West)


Eadie, Alexander
McKelvey, William


Eastham, Ken
McLeish, Henry


Evans, John (St Helens N)
McNamara, Kevin


Ewing, Harry (Falkirk E)
McWilliam, John






Madden, Max
Sheldon, Rt Hon Robert


Mahon, Mrs Alice
Shore, Rt Hon Peter


Marshall, Jim (Leicester S)
Short, Clare


Martin, Michael J. (Springburn)
Sillars, Jim


Martlew, Eric
Skinner, Dennis


Meacher, Michael
Smith, Andrew (Oxford E)


Meale, Alan
Smith, C. (Isl'ton &amp; F'bury)


Michael, Alun
Smith, Rt Hon J. (Monk'ds E)


Michie, Bill (Sheffield Heeley)
Smith, J. P. (Vale of Glam)


Morgan, Rhodri
Soley, Clive


Morley, Elliot
Spearing, Nigel


Morris, Rt Hon A. (W'shawe)
Steel, Rt Hon David


Morris, Rt Hon J. (Aberavon)
Steinberg, Gerry


Mowlam, Marjorie
Stott, Roger


Mullin, Chris
Straw, Jack


Murphy, Paul
Taylor, Mrs Ann (Dewsbury)


Nellist, Dave
Taylor, Matthew (Truro)


O'Brien, William
Thompson, Jack (Wansbeck)


Orme, Rt Hon Stanley
Turner, Dennis


Owen, Rt Hon Dr David
Vaz, Keith


Patchett, Terry
Walker, A. Cecil (Belfast N)


Pendry, Tom
Wall, Pat


Pike, Peter L.
Wallace, James


Powell, Ray (Ogmore)
Walley, Joan


Prescott, John
Warden, Gareth (Gower)


Primarolo, Dawn
Wareing, Robert N.


Quin, Ms Joyce
Watson, Mike (Glasgow, C)


Radice, Giles
Welsh, Andrew (Angus E)


Randall, Stuart
Welsh, Michael (Doncaster N)


Redmond, Martin
Williams, Rt Hon Alan


Rees, Rt Hon Merlyn
Williams, Alan W. (Carm'then)


Richardson, Jo
Wilson, Brian


Roberts, Allan (Bootle)
Winnick, David


Robinson, Geoffrey
Wise, Mrs Audrey


Rogers, Allan
Worthington, Tony


Rooker, Jeff
Wray, Jimmy


Ross, Ernie (Dundee W)



Ross, William (Londonderry E)
Tellers for the Ayes:


Rowlands, Ted
Mr. Frank Haynes and Mrs. Llin Golding.


Ruddock, Joan



Salmond, Alex





NOES


Adley, Robert
Brandon-Bravo, Martin


Aitken, Jonathan
Brazier, Julian


Alexander, Richard
Bright, Graham


Alison, Rt Hon Michael
Brown, Michael (Brigg &amp; Cl't's)


Allason, Rupert
Browne, John (Winchester)


Amess, David
Buchanan-Smith, Rt Hon Alick


Amos, Alan
Buck, Sir Antony


Arbuthnot, James
Budgen, Nicholas


Arnold, Jacques (Gravesham)
Burns, Simon


Arnold, Tom (Hazel Grove)
Burt, Alistair


Ashby, David
Butcher, John


Atkins, Robert
Butler, Chris


Atkinson, David
Butterfill, John


Baker, Rt Hon K. (Mole Valley)
Carlisle, John, (Luton N)


Baker, Nicholas (Dorset N)
Carlisle, Kenneth (Lincoln)


Baldry, Tony
Carrington, Matthew


Batiste, Spencer
Carttiss, Michael


Beaumont-Dark, Anthony
Cash, William


Bellingham, Henry
Chapman, Sydney


Bendall, Vivian
Chope, Christopher


Bennett, Nicholas (Pembroke)
Churchill, Mr


Benyon, W.
Clark, Hon Alan (Plym'th S'n)


Bevan, David Gilroy
Clark, Dr Michael (Rochford)


Biffen, Rt Hon John
Clark, Sir W. (Croydon S)


Blackburn, Dr John G.
Clarke, Rt Hon K. (Rushcliffe)


Blaker, Rt Hon Sir Peter
Conway, Derek


Body, Sir Richard
Coombs, Anthony (Wyre F'rest)


Bonsor, Sir Nicholas
Coombs, Simon (Swindon)


Boscawen, Hon Robert
Couchman, James


Boswell, Tim
Cran, James


Bottomley, Peter
Currie, Mrs Edwina


Bottomley, Mrs Virginia
Curry, David


Bowden, A (Brighton K'pto'n)
Davies, Q. (Stamf'd &amp; Spald'g)


Bowden, Gerald (Dulwich)
Davis, David (Boothferry)


Bowis, John
Day, Stephen


Boyson, Rt Hon Dr Sir Rhodes
Devlin, Tim


Braine, Rt Hon Sir Bernard
Dorrell, Stephen





Douglas-Hamilton, Lord James
Key, Robert


Dover, Den
King, Roger (B'ham N'thfield)


Dunn, Bob
Kirkhope, Timothy


Dykes, Hugh
Knapman, Roger


Eggar, Tim
Knight, Greg (Derby North)


Emery, Sir Peter
Knowles, Michael


Evans, David (Welwyn Hatf'd)
Knox, David


Fairbairn, Sir Nicholas
Lamont, Rt Hon Norman


Fallon, Michael
Lang, Ian


Favell, Tony
Latham, Michael


Fenner, Dame Peggy
Lawrence, Ivan


Field, Barry (Isle of Wight)
Lawson, Rt Hon Nigel


Finsberg, Sir Geoffrey
Lee, John (Pendle)


Fishburn, John Dudley
Lennox-Boyd, Hon Mark


Forman, Nigel
Lester, Jim (Broxtowe)


Forsyth, Michael (Stirling)
Lightbown, David


Forth, Eric
Lilley, Peter


Fowler, Rt Hon Norman
Lloyd, Sir Ian (Havant)


Franks, Cecil
Lloyd, Peter (Fareham)


Freeman, Roger
Lord, Michael


French, Douglas
Luce, Rt Hon Richard


Gale, Roger
Lyell, Sir Nicholas


Gardiner, George
McCrindle, Robert


Garel-Jones, Tristan
Macfarlane, Sir Neil


Gill, Christopher
MacKay, Andrew (E Berkshire)


Glyn, Dr Alan
Maclean, David


Goodson-Wickes, Dr Charles
McLoughlin, Patrick


Gorman, Mrs Teresa
McNair-Wilson, Sir Michael


Gorst, John
McNair-Wilson, Sir Patrick


Gow, Ian
Madel, David


Grant, Sir Anthony (CambsSW)
Malins, Humfrey


Greenway, Harry (Ealing N)
Maples, John


Greenway, John (Ryedale)
Marland, Paul


Gregory, Conal
Marlow, Tony


Griffiths, Sir Eldon (Bury St E')
Marshall, John (Hendon S)


Griffiths, Peter (Portsmouth N)
Martin, David (Portsmouth S)


Ground, Patrick
Mates, Michael


Gummer, Rt Hon John Selwyn
Maude, Hon Francis


Hague, William
Mawhinney, Dr Brian


Hamilton, Neil (Tatton)
Maxwell-Hyslop, Robin


Hampson, Dr Keith
Mayhew, Rt Hon Sir Patrick


Hanley, Jeremy
Mellor, David


Hannam, John
Miller, Sir Hal


Hargreaves, A. (B'ham H'll Gr')
Mills, Iain


Hargreaves, Ken (Hyndburn)
Mitchell, Andrew (Gedling)


Harris, David
Mitchell, Sir David


Haselhurst, Alan
Moate, Roger


Hawkins, Christopher
Monro, Sir Hector


Hayes, Jerry
Montgomery, Sir Fergus


Hayhoe, Rt Hon Sir Barney
Morrison, Sir Charles


Heathcoat-Amory, David
Moss, Malcolm


Heddle, John
Moynihan, Hon Colin


Hicks, Mrs Maureen (Wolv' NE)
Mudd, David


Hicks, Robert (Cornwall SE)
Neale, Gerrard


Higgins, Rt Hon Terence L
Nelson, Anthony


Hill, James
Neubert, Michael


Hind, Kenneth
Newton, Rt Hon Tony


Hogg, Hon Douglas (Gr'th'm)
Nicholls, Patrick


Holt, Richard
Nicholson, David (Taunton)


Howard, Michael
Nicholson, Emma (Devon West)


Howarth, Alan (Strat'd-on-A)
Norris, Steve


Howarth, G. (Cannock &amp; B'wd)
Onslow, Rt Hon Cranley


Howe, Rt Hon Sir Geoffrey
Oppenheim, Phillip


Howell, Rt Hon David (G'dford)
Page, Richard


Howell, Ralph (North Norfolk)
Paice, James


Hughes, Robert G. (Harrow W)
Parkinson, Rt Hon Cecil


Hunt, David (Wirral W)
Patnick, Irvine


Hunt, Sir John (Ravensbourne)
Patten, Rt Hon Chris (Bath)


Hunter, Andrew
Patten, John (Oxford W)


Hurd, Rt Hon Douglas
Pawsey, James


Irvine, Michael
Peacock, Mrs Elizabeth


Jack, Michael
Porter, Barry (Wirral S)


Jackson, Robert
Porter, David (Waveney)


Janman, Tim
Portillo, Michael


Jessel, Toby
Powell, William (Corby)


Johnson Smith, Sir Geoffrey
Price, Sir David


Jones, Gwilym (Cardiff N)
Raffan, Keith


Jones, Robert B (Herts W)
Raison, Rt Hon Timothy


Jopling, Rt Hon Michael
Rathbone, Tim


Kellett-Bowman, Dame Elaine
Redwood, John






Renton, Tim
Summerson, Hugo


Rhodes James, Robert
Tapsell, Sir Peter


Riddick, Graham
Taylor, Ian (Esher)


Ridley, Rt Hon Nicholas
Taylor, John M (Solihull)


Ridsdale, Sir Julian
Taylor, Teddy (S'end E)


Rifkind, Rt Hon Malcolm
Tebbit, Rt Hon Norman


Roberts, Wyn (Conwy)
Temple-Morris, Peter


Roe, Mrs Marion
Thatcher, Rt Hon Margaret


Rossi, Sir Hugh
Thompson, D. (Calder Valley)


Rost, Peter
Thompson, Patrick (Norwich N)


Rowe, Andrew
Thorne, Neil


Rumbold, Mrs Angela
Thurnham, Peter


Sackville, Hon Tom
Townend, John (Bridlington)


Sainsbury, Hon Tim
Townsend, Cyril D. (B'heath)


Sayeed, Jonathan
Tracey, Richard


Scott, Rt Hon Nicholas
Tredinnick, David


Shaw, David (Dover)
Trippier, David


Shaw, Sir Giles (Pudsey)
Twinn, Dr Ian


Shaw, Sir Michael (Scarb')
Vaughan, Sir Gerard


Shelton, Sir William
Waddington, Rt Hon David


Shephard, Mrs G. (Norfolk SW)
Wakeham, Rt Hon John


Shepherd, Colin (Hereford)
Waldegrave, Hon William


Shersby, Michael
Walden, George


Skeet, Sir Trevor
Walker, Bill (T'side North)


Smith, Sir Dudley (Warwick)
Waller, Gary


Smith, Tim (Beaconsfield)
Wardle, Charles (Bexhill)


Soames, Hon Nicholas
Warren, Kenneth


Speed, Keith
Wheeler, John


Speller, Tony
Whitney, Ray


Spicer, Sir Jim (Dorset W)
Widdecombe, Ann


Spicer, Michael (S Worcs)
Wiggin, Jerry


Squire, Robin
Wilkinson, John


Stanbrook, Ivor
Winterton, Mrs Ann


Stanley, Rt Hon Sir John
Winterton, Nicholas


Steen, Anthony
Wolfson, Mark


Stern, Michael
Wood, Timothy


Stevens, Lewis
Woodcock, Dr. Mike


Stewart, Allan (Eastwood)
Young, Sir George (Acton)


Stewart, Andy (Sherwood)



Stewart, Rt Hon Ian (Herts N)
Tellers for the Noes:


Stokes, Sir John
Mr. AJastair Goodlad and Mr. Tony Durant.


Stradling Thomas, Sir John



Sumberg, David

Question accordingly negatived.

Question, That the proposed words be there added, put forthwith pursuant to Standing Order No. 30 (Questions on amendments), and agreed to.

MR. SPEAKER forthwith declared the main Question, as amended, to be agreed to.

Resolved,
That this House welcomes the Government's proposals for reform in the National Health Service which will bring all parts of the health service up to the very high standards now achieved by the best, put the needs of patients first and secure the best value for money; recognises that to make the health service more responsive to the needs of patients as much power and responsibility as possible need to be delegated to local level in future whether in directly managed or self-governing National Health Service hospitals; looks forward to large general practitioner practices being able to apply for their own budgets to obtain a defined range of hospital services so as to improve the quality of service to their patients; and fully supports the Government's decision to proceed with the implementation of the general practitioners' new contract, the contents of which were agreed with the general practitioners' leaders on 4th May.

Road Safety

Mr. Speaker: I must inform the House that I have not selected the amendment in the name of the hon. Member for Thanet, South (Mr. Aitken).

The Minister for Public Transport (Mr. Michael Portillo): I beg to move,
That this House takes note of European Community Documents Nos. 4303/89 on road safety, 9228/88 on seat belts, 4252/89 on maximum permitted alcohol concentration for vehicle drivers, and 4156/87 and 4305/89 on speed limits; and endorses the Government's commitment to resist proposals in this area which are outside the field of Community competence, and not clearly related to the objectives of a common transport policy of the internal market.
This debate comes late in the Session, for reasons that I have explained. It deals largely with road safety matters. First, it might be appropriate to say how inadequate to the task I feel. One would normally have expected to see here my hon. Friend the Member for Eltham (Mr. Bottomley) who has long been associated with road safety matters. He gave evidence to the Select Committee on European Legislature whose report we have.
It is obviously important that the House should have the opportunity to express its views on the Commission's overall approach to road safety and on the specific proposals now under consideration. I am sure that the House is grateful to the Select Committee for its most helpful report. The Committee fitted in an oral evidence session and should be congratulated on producing a report very quickly so that we could have this debate. It is a fair report, summarising the arguments on both sides, and there is nothing significant in it with which the Government disagree.
In one crucial respect, there is nothing between the British Government, other Governments and the Commission. We all want to reduce the appalling toll of death and injuries on Europe's roads and we all want to find the most effective ways of doing so. However, we must recognise that the task cannot be carried out by simple solutions. Safety measures need to be suited to different geographical, cultural and economic conditions. They need to be carefully judged, targeted and monitored.
Two separate groups of issues are involved in the debate. First, there is the broader political and legal question about the rightness of community action in this area. Secondly, there are the safety merits of the Commission's proposals. The basic issue is whether it is politically sensible for the Community to act on road safety matters which relate almost entirely to human behaviour. Clearly, where the Community has to grapple with difficult areas to ensure the achievement of its primary objectives—economic progress and the completion of the internal market—the British accept that, and we play a constructive part in trying to find a Communitywide solution. However, we do not see road safety as one of those areas. Road conditions, social habits and outlooks, driver behaviour and police enforcement practices vary enormously from country to country within the Community.

Mr. Tony Marlow: We seem to have a potential problem. The British people thought that road safety laws were a matter for the competence of the


United Kingdom. The European institutions, probably aided and abetted by the European Court, using procedures based on a majority vote on the basis of initiatives coming from the Commission, composed basically of bureaucrats with no democratic control, seem to have taken from the British people the power that they thought they had over road safety. If that proves to be the case, how shall we recover those powers?

Mr. Portillo: My hon. Friend puts his finger on the crux of tonight's debate and that is the very issue that I am addressing. The issues have been clearly set out in the Select Committee's excellent report. I was trying to expound some of those issues. I was saying that road conditions, social habits and outlooks and driver behaviour vary from country to country, as does police enforcement practice. I agree that to try to legislate effectively from Brussels to encompass such variation risks imposing over-simple solutions on complex issues. We do not need harmonisation in this area to obtain the primary objectives of the treaty. The principle of subsidiarity should apply. Road safey measures are best decided by national Governments to suit different circumstances. I think that my hon. Friend would agree with that.

Mr. Teddy Taylor: I am grateful for what the Minister said. It gives us a splendid idea of what the Government think. But my hon. Friend must be aware that the Commission's representatives have said clearly and categorically that practically all these measures are covered by the common transport policy which enables any other appropriate provisions to be made. The House would like to know whether the Government take the same splendid view. If the Commission's view is wholly different, as it is, what can we do about the proposal before us and a host of other imminent proposals, in which the Community is extending the EEC's powers by stretching the treaty of Rome and the Single European Act?

Mr. Portillo: We are dealing here with a disagreement between the Commission and the British Government, which the Select Committee report describes well. I point out to my hon. Friend the Member for Southend, East (Mr. Taylor) that all the matters covered by the report and which are the subject of tonight's motion were taken before the Council of Ministers but did not find favour there. The British Government opposed Community competence, and fortunately our view found favour with other member States. None of the provisions included in the motion has been adopted by majority voting, contrary to the wishes of the British Government, because a blocking minority in the Community clearly shares our view.

Mr. Marlow: My hon. Friend said that there has been a blocking minority, but I understand that when it came to tyre tread depths, that blocking minority evaporated. Therefore, we found that we were outvoted and that the measures were imposed on us. These are more important measures, to do with road safety, drink-driving, seat belts and road speed signs. My hon. Friend said that he is opposing what the Commission is trying to put forward. Supposing that my hon. Friend is defeated.
Supposing that the Government are defeated, and the Commission, through its various machinations and

through use of the European Court—to help it to use majority voting where the Government do not believe that it should use majority voting—succeeds? What then will we do about it? How then are we going to get the powers back to this House? That is what we are here for—to exercise powers, to exercise the sovereignty of the British people. We had it recently over signs on cigarette packets, when we lost that one. How are we going to get it back?

Mr. Portillo: My hon. Friend asks a series of hypothetical questions. He is saying that, so far, our Community partners and ourselves have formed a blocking minority so that the proposals in question could not be adopted. Therefore, our policy must be to continue to oppose the proposals and to encourage our Community partners who form the other part of the blocking minority to maintain the same view.
My hon. Friend asked me also about the measure on tyre tread depths. He will appreciate that that is not the subject of tonight's motion, but he is right to say that, in that instance, the blocking minority evaporated. The motive behind the decision by some of our Community partners not to back us on that issue related to their belief that there were broader considerations relating to freedom of trade within the Community. Whether or not one agrees with that point of view—as the British Government do not, they voted against that proposal—the same argument was advanced by other member states. Therefore, that would not be a promising case to take to the European Court.
As to the proposals now before the House, I give my hon. Friend a pledge that we shall continue to resist the Commission's proposals. If we are defeated in due course—although I have no reason to think that we will be—we should have to consider taking our case to the European Court.

Dr. Norman A. Godman: With this measure, as with 1,001 others emanating from Brussels, we are witnessing the continuing diminution of British parliamentary sovereignty. To answer the hon. Member for Southend, East (Mr. Taylor), there is little or nothing that the Government can do about Community measures relating to road safety or to the fishing, steel, and many other industries. We are witnessing the remorseless diminution of our parliamentary sovereignty.

Mr. Portillo: We are witnessing the consequences of a series of decisions, taken by Parliament over a period, to bring the United Kingdom into the European Community and to make it a signatory to the Single European Act. The British Government doubt the Commission's competence to advance proposals arising from that.
There are two ways in which those proposals can be resisted. In the first instance, the British Government can oppose them and seek to make common cause with other Governments who take the same view: that tactic has been deployed successfully in the case of the measures that we are discussing this evening, which were not adopted owing to a blocking minority. If, however, we were unable at some future time to sustain that blocking minority and some of the measures were adopted, and if we continued to doubt the competence of the Commission or the Community, it would be open to the British Government to take the matter to the European Court, where the treaty of Rome and any other relevant provisions could be interpreted.

Mr. William Cash: If our Government and the legal advisers to the Select Committee on European Legislation consider that a measure goes beyond the competence of the treaty, there are other options, not least the opportunity to exercise a veto. It really is not good enough to assume that the only possible route leads to the European Court of Justice: that is a protracted and uncertain route, especially in view of the political integrating policy of that court. Will my hon. Friend be good enough to tell us whether the Luxembourg accord has been considered, and whether we propose to exercise it in this case?

Mr. Portillo: So far, consideration of that has not been necessary, because it has been possible to bring about a blocking minority in the matters that we are discussing. The United Kingdom Government will, of course, be willing to consider any means of carrying forward their view that such matters go beyond the competence of the European Community.

Mr. Roger King: May I pursue a slightly different tack? Why can we not adopt a common policy on drink-drive levels within the European Community? Presumably we have common standards for airline operation because the flights transcend national boundaries, but does not the same apply to motor cars, heavy goods vehicles and coaches? What is wrong with arriving at common standards on a voluntary basis?

Mr. Portillo: In the unlikely event that I am allowed to progress with my speech, I intend to deal with that later. I see no reason why we should not have the same standards in every country, but I think that there is a strong argument against the imposition of that by the Community. Perhaps my hon. Friend's question should be my cue to make faster progress.
We consider our line of argument to be one endorsed by the treaty of Rome. The founding fathers were political realists as well as idealists; nothing in the general articles at the beginning of the treaty—or in the transport chapter—suggests that the development of common road safety policy and rules was ever perceived as a necessary part of Community activity.
Arguments may be put to the contrary: the issue has never been tested head-on before the European Court. One particularly relevant case, mentioned in the Select Committee report, is the Schumalla case, which goes a long way to suggest that the court would share our view if the matter was ever tested to the full. In that case the Court's Advocate-General, in his analysis of the legal issues involved, suggested that road safety could be seen as an objective of the treaty, and it is on that opinion that the Commission relies. In its final judgment, the court seems studiously to have avoided endorsing the wider arguments suggested by the Advocate-General. The omission of any endorsing comment suggests that the full court, when confronting those arguments, had serious misgivings about them.
The Commission relies on what it calls the "precedents" for legislation on transport safety. The main examples are the drivers' hours legislation on road transport and various maritime transport measures which have significant safety implications. In each case, the primary purpose of the measure is something other than "pure safety". The drivers' hours legislation is primarily about competition; the maritime measures are primarily about

Community trade. We have no problem with measures which serve the primary objectives of the treaty arid have related safety benefits. We give a positive welcome to the concept that the Commission should give more weight to safety considerations in many of its proposals, but that is different from bringing forward pure safety measures which have little or no relevance to the Community's primary objectives.
The House may wish me to go into the safety merits of each of the proposals later, so for the moment I shall be brief. The essential point is that the content of the proposals heavily underlines why it is unnecessary and inappropriate for measures such as this to be enacted at Community level. We are far from satisfied with the United Kingdom's road safety record, which is why we set the target of reducing road casualties by a third by the year 2000. We are constantly on guard against complacency, but the fact remains that we have the best road safety record in the European Community. Although we are not among the best on some specific aspects of road safety, the Commission's proposals are concerned not with any of them but with driving and occupancy of motor vehicles, on which our record is second to none.
On drinking and driving—this answers the question asked by my hon. Friend the Member for Birmingham, Northfield (Mr. King)—the Commission proposes setting a legal limit of 0·5 per cent. The legal limit in the United Kingdom is 0·8 per cent., as it is in most other Community countries. Even in the United Kingdom, where drinking and driving has been falling significantly over recent years, over half those convicted have consumed more than twice our current legal limit. Moreover, there is little evidence of a significant accident or casualty problem for drivers who have consumed between 0·5 and 0·8 per cent., although evidence is not easy to obtain.
In the light of those considerations, we do not believe that it makes sense to invite the police to diversify their enforcement effort instead of continuing to concentrate on the worst offenders and those above the current limit. We believe that the same applies for most Community member countries. If circumstances in other countries are different, we should be the last to suggest that they should adopt a strategy that does not fit their circumstances.
Much the same is true for the proposal on speed limits. The Commission has addressed only passenger transport and goods vehicles. In general, those vehicles have a better than average safety record. In this country at least, many coaches are equipped with speed limiters. As 75 per cent. of casualties occur on local urban roads, the speed limits suggested by the Commission have little relevance to casualty reduction. If another car or person is hit by a bus, coach or lorry, even at much lower speeds than those under discussion, the results can be serious.

Mr. Teddy Taylor: We have been provided with helpful papers showing that under the EEC's proposal we might have to spend many millions of pounds changing our road signs from a speed limit of 30 miles per hour for vans and goods vehicles to 31 miles per hour, which is quite a significant change. Will permanent derogation ensure that that will not happen? Does the Minister accept that it would make not only the Common Market but the Department of Transport look terribly stupid if we were made to change our signs from 30 mph to 31 mph? May we be assured that we have a permanent derogation from the metrication which would make 50 km an hour apply?

Mr. Portillo: Although I am anxious to answer my hon. Friend's question, I fear that my inadequacy must show, being a late stand-in for my hon. Friend the Member for Eltham, who would have been able to answer immediately. I shall, however, take pains to answer my hon. Friend before the end of the debate.
As to whether I believe that it would be foolish for us to have to change our 30 mph speed limit to 31 mph, I concur with my hon. Friend, who gave an extremely good illustration of the problem that faces us in this area. He has done more than anybody to point out the ludicrousness of some of the suggestions that are being made.
There is the proposal to make seat belt wearing mandatory. Here, the content causes us fewer difficulties. Front seat belt wearing is already compulsory in this country, and we have already made it clear that the compulsory wearing of rear seat belts is our aim. The point at issue is, again, whether it is sensible to legislate on this at Community level.
Our 95 per cent. compliance rate with front seat belt wearing stems almost entirely from the fact that public opinion was ready for, and supported, the regulations when they were introduced. If we want the same to apply to rear seat belt wearing, we need to assess again the readiness of public opinion for such a change. With front seat belt wearing so widely accepted, I do not believe that there will be any significant difficulty. We also need to consider the proportion of vehicles that are equipped with rear belts. There is little point in making the requirement mandatory until, at the very least, half the vehicles on the roads are so equipped.
As it happens, that is likely to be the case in this country by about 1992, which is the date the Commission proposes for the introduction of mandatory belt wearing. But although that is true here, it may be possible to move faster in some countries, while others may not be ready for many years longer. In principle, we support the safety aspects of this Commission proposal, but again, it illustrates the difficulties and potential dangers of seeking to legislate, in this sort of area, at Community level.
We are all striving for the same objective—the reduction of deaths and serious injuries on Europe's roads. But for fundamental legal reasons, and for the sake of effectiveness, measures should be considered, initiated and monitored at the political level which is most appropriate. In the case of the proposals under discussion, the right level is that of national Governments in co-operation with local authorities. They are not right for action at Community level.

Ms. Joan Ruddock: I must at the outset acknowledge our disappointment at the departure of the hon. Member for Eltham (Mr. Bottomley) from his post and the loss of his unusual sense of humour, which we were beginning to enjoy.
We are considering tonight five European Community documents relating to road safety. As the Minister said, the debate must address not only questions of policy and the issues arising from the European Commission's proposals, but whether, at a more fundamental level, the commission is going beyond its powers in drawing up these proposals.
The Minister argued that there is no competence within the Community's legal framework for these measures—

that is, that there are no, or only dubious, legal grounds to justify the Commission's measures. The Government argue that article 75 of the treaty of Rome provides for the adoption of measures within the framework of a common transport policy to implement the treaty's objectives. Those objectives are the removal of restrictions on trade and the removal of obstacles to free competition. The Minister is therefore arguing that. where those primary objectives are not met, the European community has no power or competence to adopt any other measures relating to transport.
The Government have made it clear that they will accept Community competence only in the area of harmonising vehicle standards which relate directly to competitiveness. But they have set their face against measures proposed on safety grounds alone. My hon. Friends and I note that that view is not unanimous in member states, although the Government have said that Germany and Denmark at present share their position.
In an interesting presentation to the Select Committee on European Legislation, to which the Minister referred, the European Commission set out its justification for the measures. According to the Commission, article 25 left it open to the Community to adopt
any other appropriate measures relating to the implementation of a common transport policy.
Hon. Members may be aware that the treaty of Rome mentions transport, agriculture and fisheries as sectors that are moving towards a common policy and, in the Commission's words,
In these sectors you have all room to manoeuvre".
The Commission cited a legal case to which the Minister referred, the Schumalla case, in which the Advocate General has advised that road safety of itself was an objective of the treaty, as was rail and inland waterway safety. The Commission argued that safety issues directly affect the play of market forces and that accidents have economic and financial consequences.
It seems clear to us that a court decision is needed to settle the issue, which appears to hinge, as the Sub-Committee states,
on different interpretations of the Schumalla case".
However, we believe that a legal framework that is so narrowly based on freeing up the market and allowing unfettered competition is an inadequate basis for promoting a coherent and integrated Community transport policy. Much is made of the need to harmonise standards in preparation for 1992 and the single market. Should not equal attention and value be given to the social and human consequences of 1992, to improving working conditions and safety standards and to giving environmental considerations a far greater role and value than hitherto? Unless that is done, if the Government's view prevails, the single market will work for the benefit of the few, not the many.
If the European Commission puts forward sensible proposals within the transport sector that advance road safety or, for instance, stimulate the commitment of member states to protect the environment as a key factor in their transport policy, we believe that the Commission should be supported. The Opposition support good proposals, whatever their source.

Mr. Marlow: The hon. Lady has just said that the Opposition would support good proposals from the Commission. Would they do so even where the Commission did not have competence?

Ms. Ruddock: I have made it plain that the issue of competence is not clear, either in the Select Committee's report or in the Government's statement, and that, to determine this matter, there would have to be a court case. However, the hon. Gentleman will understand from looking at the Select Committee's report and at the evidence of the Commission's legal adviser that the Commission believes that the Government's case would not succeed in court, because article 75 allows for the possibility of proceeding on the ground of road safety measures alone, without additional measures relating to competitiveness.

Mr. Marlow: The hon. Lady's original statement was wider than that. She said that she would support good ideas from the Commission, not necessarily just the ideas that we are considering in the debate. Does she mean that she would support any good ideas, whether or not the Commission had competence?

Ms. Ruddock: We would support any ideas on their merits. It is always possible, even if there is not agreement among all member states, for states to support good ideas and introduce them in their national Parliaments. The Minister has argued that such measures are best left in the hands of national Governments who are more in tune with national behaviour and social norms. I do not see why both paths cannot be pursued.
I acknowledge and applaud the efforts by the former Minister for Roads and Traffic in reducing road casualties and in promoting road safety. I hope that the Minister for Public Transport and his new colleagues will continue to make road safety a priority, as the Opposition have long argued. The former Minister acknowledged in his evidence to the Sub-Committee that, if he were the Commission, he would try to find every peg on which to reduce road casualties, and surely that must be the duty of all of us. He spoke also of the progress that could be made on those measures where there was doubt about Community competence, principally on design modifications to vehicles. We would support all the measures to which he referred, such as technical changes, improved seat belts, softer steering wheels and better protection on motor bikes.
The proposal that is most contentious and most strongly resisted by the Government is the draft directive on the maximum permitted alcohol concentrations for vehicle drivers. We have heard that the Commissioners propose to set the maximum alcohol limit at 50 mg. It is currently 80 mg in the United Kingdom. The Minister has outlined his reasons for his opposition to lowering the limit, and in what he says there is much with which we agree. Working to influence attitudes towards drinking and driving at all levels is vital, and a focus on the drinking limit may have the effect of implying that it is safe to drink up to that limit.
A strategy of public education and stricter enforcement has resulted in a gradual reduction in accidents resulting from drinking and driving, but the toll still remains unacceptably high. About 900 to 1,000 people are still killed on Britain's roads as a result of drink-driving, and more than 20,000 are injured annually. More steps are needed further to reduce the rate, and it may be that a reduction in the limit will be part of a package of measures

designed to reduce drink-driving, although, like the Minister, we are doubtful of its effectiveness as a single measure.
A more productive measure, for which there is widespread support in the House and outside, would he the introduction of random breath testing. We would support highly visible, systematic mass testing at roadside check points, but because of the possible abuse of people's civil liberties we would not support providing the police with unfettered powers to stop and test at their own discretion.
The value of random breath testing is as a deterrent to drivers. Its secondary role is as a detector. We would support such a measure, and we hope very much that the new Minister for Roads and Traffic, the hon. Member for South Ribble (Mr. Atkins), will soon be making it clear to the House where the Government stand.
I move on to the draft directive on seat belts. There is little disagreement between ourselves and the Government.

Mr. Rupert Allason: I think that I might have missed something. Perhaps the hon. Lady will be kind enough to explain what the difference is between random breath testing and calling drivers into the side of the road in a visible way, as she described, which is surely random breath testing as well. I do not understand the difference between the two.

Mrs. Ruddock: There is a significant difference. Accompanying the introduction of random breath testing is the need scientifically to randomise it. The check must be truly random. For example, one would stop one vehicle in 100, 500 or whatever. If discretion is left entirely to the police officer, there is always the possibility that that individual will choose certain types of vehicle or drivers. That can arouse suspicion among drivers that they have been picked on for some purpose other than pure random testing. It is a serious consideration for civil liberties. I can say from my constituency experience that there are many complaints from young black people who consider that they are stopped disproportionately often. If we have a random system, we must be careful that we can demonstrate that it is truly random.

Mr. Bowen Wells: Does the hon. Lady believe that the type of testing which she has described, with which I have much sympathy, should be imposed by national Parliaments' decisions or by the Commission? She appears to be willing to consider imposition by the Commission.

Ms. Ruddock: We are not talking about a measure that the Commission has proposed.

Mr. Wells: Not yet.

Ms. Ruddock: The hon. Gentleman may be correct. We agree with the Government that what the Commission is currently proposing—a reduction in the permitted alcohol level in the blood—is not the present priority. I acknowledge that in the fight to reduce the number of drink-drive offences we need to introduce new measures. The priority of groups such as the Parliamentary Advisory Council on Transport Safety is deemed to be that of random testing. If the Commission were to bring that forward, I am sure that it would have


our support. We know that with 1992, drivers will be constantly crossing national boundaries. There is sense in having measures equalised throughout the Community.
Perhaps, I can continue with my speech, or I shall be taking too much time from other hon. Members who wish to participate in the debate.
There is virtually no disagreement between the Government and ourselves about seat belts. The Commission proposed to make the wearing of seat belts compulsory for all occupants of cars, with certain exceptions. Again, we know from the surveys by the road research laboratory that only 6 per cent. of adults use rear seat belts, but that the use of them could save about 70 per cent. of rear seat fatalities. There were 25,000 casualties in 1987, 4,000 of which were fatalities. We very much support the wearing of rear seat belts. There is a difference between the projections of the Parliamentary Advisory Committee on Transport Safety and of the Government about the percentage of cars that will be fitted with rear seat belts. PACTS believes that 45 per cent. of all cars will be fitted with rear seat belts by the end of this year. I urge the Minister to re-examine the figures, because it may be possible that, even if we are not going to act within the Commission, we can act on the national question sooner rather than later.
The Commission has justified its proposal to harmonise speed limits on several grounds, the least persuasive of which was that speed limits have a direct effect on prices and that a distortion of competition could result from different speed limits in different countries. We tend to agree with the proposition that adequate signing is equally important, so that drivers crossing borders are aware of the different speed restrictions. Secondly, speed limits are closely related to congestion problems in each country and, as such, are not perhaps appropriate for community harmonisation. Having said that, we acknowledge that there are arguments for bringing down some speed limits. Evidence shows that reducing speed limits can reduce the accident rates, although a judgment needs to be made as to at what point a reduced speed limit may result in it being disregarded.
There is a strong case for lower speed limits for buses and coaches, as outlined in the Commission's proposal. Many motorists feel threatened by the speed and size of

coaches travelling in the fast lanes of our motorways and passengers in such coaches, especially in double deckers, are frequently concerned about safety.

Mr. Roger King: Clearly, the hon. Lady will have studied the accident record of coach travel in this country and on our motorways. Is she aware that the biggest operator in western Europe has not harmed a passenger in three and a half years?

Ms. Ruddock: I am aware of that. I did not make any claims about safety. I simply referred to the effect on other drivers on the motorways and the feelings of many passengers on those coaches.

Mr. King: They do not feel that way.

Ms. Ruddock: They do.

Mr. King: I travel on coaches.

Ms. Ruddock: The hon. Gentleman may have travelled on them, but many people who have also travelled on them have spoken to me about their concerns. Anyone who is driving down a motorway at 70 mph, and is passed by a double-decker coach, is somewhat intimidated.
The points which I wish to make on speed do not just concern safety. We need to work to increase an awareness among motorists of the environmental consequences of speeding. High speeds produce higher vehicle emissions and lower speeds reduce vehicle emissions, especially nitrates and oxides. The Commission states that a reduction in average speeds in the Community to 100 km per hour could reduce car emissions by 10 per cent. That is an important factor which we also need to take into account.
All the specific proposals are set out in the context of a continuing programme of road safety work undertaken by the Commission, as set out in its document on road safety. The arguments about the legal basis of the Commission's proposals have already been rehearsed. They should not obscure the fact that, with 50,000 people dying and 1·6 million injured each year on Community roads, much work still needs to be done.
We note that the legal adviser to the Commission has said that a proposal related to road safety per se would stand a good chance of being accepted as falling within article 75. However, as the Minister has said, the matter is currently academic because of the blocking action of member states, and we are content to leave it as it is.

Mr. Teddy Taylor: I hope that the hon. Member for Lewisham, Deptford (Ms. Ruddock) will listen carefully to my brief comments. She said that the Commission is saying some wise and knowledgable things. Perhaps it is because I am sure that there is no group of people in the world that does not say wise things from time to time, but we may differ about their wisdom.
I hope that from the point of view of constitutional democracy, the hon. Lady will be careful about what seems almost an obsession to pass over the right to make decisions to something that is not democratic in the sense in which British people have always understood our way of making laws. I hope that the hon. Lady will accept that when proposals come forward from an unelected body such as the Commission, when the powers of the various organisations are decided by the non-elected European Court, and when the final decisions are made by the Council of Ministers, who often "swop" support in different councils on the basis of what is happening, we are moving many miles away from democracy as we understood it. I therefore hope——

Ms. Ruddock: I am sure that the hon. Gentleman is entirely innocent in this matter, but it was his Government who agreed to all these measures and powers for the Community.

Mr. Taylor: I accept that the decisions on the treaty of Rome and on the Single European Act were made by Parliament—I happened to vote against them and that is my own business—but they are now the law of the land. I hope that the hon. Lady will hear very much in mind the fact that if those powers are consistently and regularly extended by the Commission when there is insufficient protection for member states to do something about it, we have a serious constitutional problem.
We know that there are only two things that the British Government can do if a directive is brought before the Council which they think is in excess of the powers of the Community under the terms of the treaties that we have approved. First, they can seek to get the Council unanimously to say no, if it is a question of majority voting. However, it is very rare for that to happen and I am not aware of any decision in which that has happened—[Interruption.] Yes, at its first meeting the Council of Ministers can say no unanimously, but to my knowledge that has not happened.
Secondly, one can go to the European Court. The hon. Lady will be aware that in a large majority of the cases—even in the minority, there were other factors—the court has consistently supported extensions to the powers of the institutions of the Community.

Dr. Godman: Is it not the case that domestic legislatures have little or no control over the decision-making of the European Commission and that domestic Parliaments have no control over Council of Ministers' decisions? Therefore, is it not almost inevitable that over the next decade or so the Strasbourg Parliament will gain more and more power as Parliaments such as this lose power?

Mr. Taylor: I agree with almost all that the hon. Gentleman has said, but there is no question of the

Strasbourg Parliament getting all the power. When the EEC is based on the initiating power of the Commission, on the decisions of the Council of Ministers, and on the extension of its powers by the Court, there is no role for the European Parliament. There could be a role if we had a European Government. If we had a European Foreign Secretary, a European Chancellor of the Exchequer and a European Parliament, with nothing but a county council at national level, those powers could rest with that Parliament.
The hon. Gentleman must be well aware that for the present, and in the immediate future, if the European Parliament were to disappear, tomorrow, nobody would notice. Indeed, on these issues, if this Government and this Parliament were to disappear nobody would notice. Even if all of us decided—I exclude the new Minister of Agriculture, Fisheries and Food, because he may feel that this is not one for him—to reject this whole business, it would not have the slightest effect on what the Minister might do.
We must appreciate that we are facing a serious democratic issue. That is why some of us have asked the Government, if they think that this is an extension of Community powers, to try to do something about it. We must remember that we have given certain powers to the EEC, and if it is going out of its way to extend those powers unreasonably, the Government must do something about it. That is why we have to go all the way to the European Court. Although the answer might be no, we have to make it clear that we are not happy with the way in which things are going.
Ultimately, given the way in which the Commission is working, almost nothing will be our business. Almost every decision will be taken by the European Community, sadly, in a society which is basically not democratic. That should worry us, and the Government.
The Minister, sadly, did not refer to what I regard as terribly important proposals—those on driver licensing. The Minister will be aware of the Common Market's latest ploy, which involves those wonderful vehicles to which some of us have subscribed—the special minibuses which transport blind and disabled people. They are run by wonderful charities and driven by volunteers, and have fabulous safety records. The latest proposals are for a special licence category and trained drivers.
I have received many letters from charities asking what will happen to them. I have had to reply that I cannot do anything about it, as it has all been decided in Brussels. Will the Minister make the position abundantly clear? Is he saying that the proposals are blocked? Can the charities therefore forget about the matter? Alternatively, is the question still open? The Minister must be well aware that the proposal is causing the charities huge concern and they would like to know exactly where they stand. It is on page 3 of the memorandum issued on 8 March 1989.

Mr. Roger King: I believe that the matter has been resolved successfully and that it is all right for existing drivers to continue operating minibuses with up to 17 seats. In future it may be necessary to have a higher standard of test for such vehicles. We would welcome that as it would improve safety records. Running those vehicles is an important task. We need to ensure that those who drive the vehicles, which are often loaded with scouts, cubs, football teams and so on, attain a very high standard of driving.

Mr. Taylor: My hon. Friend the Minister will probably disagree with my hon. Friend the Member for Birmingham, Northfield (Mr. King) as he is aware that the standard of driving of those volunteer drivers is about the highest of any group of drivers in the country. My hon. Friend should also be aware that some of our leading charities have written to say that if they are forced to take all their new drivers as trained drivers, unfortunately those vehicles will have to stop carrying blind and disabled people, not because of a decision taken by the Government, but because of the directive. The Commission may consider it appropriate for Europe, but why on earth should we be forced to say that trained drivers must drive the minibuses for which most of us have collected cash or contributed to and believe are important to take disabled people on trips to the seaside and regularly on other journeys?
I hope that the Minister will tell us the score. Will new drivers have to be specially qualified, adding enormously to the costs of operating the minibuses, or has the matter been entirely blocked? It does not say so in any of the documents, and we should like to know.
My second question concerns speed limits. The Opposition did not comment in detail on the proposals for speed limits. I was hoping that they would. I hope that those who study such matters will look at page 2 of the document issued on 22 February which puts forward proposals that for a large number of vehicles, the 30 mph speed limit should change to 31 mph, the maximum rate for certain goods vehicles should be reduced from 70 mph to 62 mph and for others the maximum of 60 mph should be reduced to 50 mph. Those are fundamental and important changes. The Government have said that to change the signs for some of those limits would cost £10 million. There are many worthy causes for which £10 million could be used, but I do not see how it will help society or the cause of the Common Market to spend £10 million on changing signs from 30 to 31. Apart from the road signs, many official forms would have to be changed.
I understand that we can get out of this if we obtain something called a permanent derogation. Even the Commission, despite what the hon. Member for Deptford says—I know that she agrees with it—and a commissioner who wants a united Europe would say, "If they have a 30 mph limit and we want a 31 mph limit, it does not make a great deal of difference." We could split the difference and call it 30·5 mph. I think that it is something that we can resolve.
The Minister may say, "Do not worry about it, we have a blocking minority"; but he will know that such a minority disappears. We have to ask whether we can stop provision being made long term, and the answer is that we can—if we have a permanent derogation. It would be crazy and confusing if some vehicles had a speed limit of 62 mph, others had a limit of 44 mph, and still others had a limit of 50 mph.
What is wrong with our speed limits? If they are wrong, we can probably sort them out. If the buses are going too fast in the constituency of the hon. Member for Deptford, we can resolve it. What is the need for this obsessive commitment to get everyone harmonised on 31 mph? If, as the driver of a van, my speed limit was 44 mph, I would say not that that improved road safety but that it added to confusion.
The Government agree with me. They say that the proposals would lead to unsafe bunching, to an increase in

journey times, to increased costs and to a reduction in the competitive position of road transport and the freight industries in relation to other transport modes. I should have thought that they would appeal to the Labour party—they will undermine public transport. I am sorry to see the Labour party fulfilling the role that we used to expect from the old Liberals, now the SLD or whatever it is called—that everything from the Common Market is to be approved of. It seems that the more that we can give to Brussels, the more likely we are to get the uniform Socialism that Labour wants. In view of that, I hope that the Government will appreciate that we have a problem. We must do something to stop silly, costly measures.
I refer only to the Front Bench of the Labour party. Quite a number of Back-Bench Labour Members are still sensible and do not want this nonsense. They want to try to preserve the rights of a free democracy. I hope that they will exercise the same power over their Front Bench as some of us are exercising, with great success, on our Front Bench, which has resulted in a change in the Government's attitude to these issues.
We must accept that the Government have said that there is a problem of competence here. They told the Select Committee on European Legislation that they have substantial objections on competence grounds. The Commission said that it can do almost anything because article 75 refers to, "any other appropriate provisions". That means a lot.
I was sorry to hear the Minister say that the Schumalla case confirmed that everything is okay because the Commission's chief legal officers took the opposite view. The title of the case was "Road Safety", and a sentence in the penultimate paragraph of the judgment said that the safety of transport by road, rail and inland waterway was indeed an objective of the common transport policy.
I hope that the Government will give us some idea of where they intend to go on this extension of policy. They cannot simply ignore it and say that they have a blocking minority in the meantime. This is a growing and continuing problem, and we would like to hear from the Government what their long-term policy on such matters will be. Can we stop silly things happening? Can we stop a 31 mph speed limit permanently?
I hope that the Government will make it abundantly clear to the Common Market that, although there may be some wise and even sensible men there, we do not like their seizing powers, and that the Government are determined to do something about it.

Mr. Roger Livsey: I know of no proposals from the Commission to abolish miles, nor of any to abolish hours. There needs to be an injection of common sense into the debate. The hon. Member for Southend, East (Mr. Taylor) made points of academic interest. I hope that common sense will prevail and that we shall retain a 30 mph speed limit.
I would like the Minister to reassure us, as his predecessor did some weeks ago, that the problem of volunteer drivers has been overcome. I am a volunteer driver on some weekends and I expect to be able to continue to be one under a licensing system that makes allowances for the vast number of volunteer vehicles on


the roads. His predecessor said that he would make strong representations on the matter, and I trust that they have borne fruit. Perhaps the Minister will confirm that later.
The objectives of the documents are desirable, although the means of achieving them are somewhat contentious, and that has taken up much of the debate. However, having signed and voted for the Single European Act, there is little we can do to unscramble some of these matters. The element of common sense should, perhaps, be applied here.
One of our problems is the need to strengthen the European Parliament. We receive many directives, like tablets of stone, from the Commission, which we are supposed to follow to the letter. If the European Parliament were stronger, it might have more impact on the Commission and be able to bring about some reforms in that respect.

Mr. Cash: rose——

Mr. Tony Marlow: The hon. Gentleman seems to have stirred up a hornets' nest. Will he remind the House when it was explained to the House, how it was explained to the House and how clear it was to him at the time that the Single European Act meant that transport policy would be totally within the competence of the European Community and that it would be totally within the competence of the European Community on the basis of majority voting? I was here all the time and it never occurred to me.

Mr. Livsey: As I understand it, transport was one of the points incorporated in the treaty of Rome. That is now history. We are involved in a rather academic debate about it now. We are confronted this evening with documents that the Commission wishes to implement.

Mr. Nigel Spearing: The hon. Gentleman is perfectly correct in saying that the Single European Act did not particularly affect the issues we are discussing. However, is he aware that, neither under the Single European Act nor previously, would these matters have gone for a second round to the European Parliament after the initial opinion? Is he therefore advocating that they should do and that many other issues should do? In that case, what is he expected to be doing here?

Mr. Livsey: The hon. Gentleman must recognise that we are set on a path to greater European integration. That will undoubtedly take some time, and it is taking a long time already. Some Europeans believe that we are not moving fast enough and there are a variety of views in the House on the topic. However, we should get back to the documents.
The objective of reducing deaths on the roads of Europe is laudable. The figure for those injured—other hon. Members have mentioned a figure of 1·6 million—is enormous and the number of injuries in a single year on the roads of Europe equates with figures for the second world war. When 50,000 people a year die, it is equivalent to wiping out a town the size of Hereford or Merthyr Tydfil, for example, every year. It is a serious problem, and we should not sell ourselves short in wishing to improve matters.
I know that the Government are attempting to improve matters. Britain's record on road safety and road deaths is extremely good, but that does not mean that there is no room for improvement in future. I would certainly support

measures to achieve improvement. Successive Governments have introduced measures to reduce the number of road deaths. We are somewhat ahead of other Community countries in that respect.
We must consider each item on its merits. Stringent tyre tread depths have been implemented in Europe, and that will help road safety in this country. It is difficult to achieve the harmonisation of speeds, because there are different road conditions in this country. It is highly desirable to reduce the alcohol limit—50 ml per litre of blood is a controversial figure, but, none the less, it is a move in the right direction. To achieve adequate road safety, no driver should drink at all.
Many crocodile tears have been shed about Europe's powers, but, whether or not we like them, they exist. We must try to see the matter through in the best possible way.

Mr. Bill Walker: Will the hon. Gentleman give way?

Mr. Livsey: I will not give way, as I am coming to the end of my speech.
We must examine road safety and related matters in greater detail. I refer in particular to speed, in relation to which it is more difficult to achieve harmonisation.

Mr. Bowen Wells: Hon. Members are, or should be, dealing with a common-sense matter—the way to reduce deaths and injuries on our roads. The Commission should proceed in the time-honoured and traditional manner in which many European states have constitutionally proceeded, and that is to devolve this type of decision-making to national Governments, local governments and other authorities. These matters concern culture, tradition, and road conditions, which differ greatly in various parts of the Community.
I direct the Minister to the idea of subsidiarity when arguing these matters in the Council of Ministers. Europeans would understand such an argument. It is not offensive to greater European unity. It is a method by which we could proceed harmoniously to produce the road safety measures that we are discussing. Such measures would be understood by the people who use the roads in the Community and they would be enforced by the police. We will enforce such measures only if they are supported by ordinary people in the Community.

Mr. Cash: My hon. Friend invokes the principle of subsidiarity. That is based on the assumption that the Commission is the remotest degree interested in reducing its powers to the point at which it would leave such matters to member states. Does my hon. Friend agree that, if it is proposing to invoke a common transport policy as the basis upon which it would take up this matter and proceed with it as it is at the moment, there is not a cat in hell's chance that it would agree to the principle of subsicliarity?

Mr. Wells: My hon. Friend makes an extremely good point. The Commission is entrusted with the duty of taking all initiatives and making all proposals to the Council of Ministers. Our hon. Friend the Minister will attend the Council of Ministers, so it is to there that our arguments and ideas must be directed. We want to reject the proposed legislation on the three matters before the House. The Council must ensure that road safety is a


matter of subsidiarity. Although there is some dispute about the powers of the Commission, they might prevail in a court. Nevertheless, for the reason of common sense, the Commission should not proceed.
The first matter relates to the amount of alcohol a driver can consume before committing an offence. In this country, the permitted level is 80 ml of alcohol per 1,000 ml. of blood, but in the remainder of the Community the level is 50 ml. The question is, what are the cultural traditions on the drinking of alcohol in the various Community countries? In Bavaria, for example, employers regularly supply workers in their factories with cold drinks—not Pepsi Cola or other soft, non-alcoholic drinks, but Bavarian lager. It is normal practice for them to drink lager throughout the day. In Britain, such a practice would probably induce a large number of people leaving work to drive while over the alcohol limit. That is just one example of how cultural traditions play an important part in the decision on the correct level under which people are permitted to drive.
In other parts of the Community access to alcohol for young people is severely limited. If they took in as much as 50 ml it would be dangerous because they are not used to alcohol and their judgment and driving skills would be affected. Decisions on this matter should therefore relate to national traditions and be covered by national, not Community, legislation.
It has been argued that one should not drink and drive at all, but that is not the law of this country or that of most of Europe. The law allows people to drive below a certain level of alcohol in the blood. The decision on what alcohol limits should be set has nothing to do with competition between the various Community countries, and it is through the anchor of the competitive element that we should try to make Europe a common market.
If, by having different regulations, one Community country achieved an advantage over another, there should be a common European standard. However, alcohol content and back seat belts cannot be anchored to a competitive advantage for any country. There might be a slight argument of competitive advantage on the issue of speed limits. However, as speed limits on roads in any Community country will apply equally to any driver, from wherever he comes in the Community, they are in fact all on the same level. All drivers should check the speed limits applying to roads—whether 30, 60 or 70 mph—and they should remain continuously aware of them. Having the same speed limits throughout Europe—especially the ridiculous change from 30 to 31 mph—would make absolutely no difference to road safety. It would not save a single life or a single limb.
This is not just a matter of whether the Community has competence in this matter, it is simply a matter of common sense. I appeal to the European honoured tradition of subsidiarity—that a law should not be made at a higher level if it can be made at a lower level and thereby gain consent for that law and aid its enforcement.

Mr. Nigel Spearing: The hon. Member for Hertford and Stortford (Mr. Wells) has put his finger on the important difference between scientific specification, particularly for vehicles, depth of tyre tread

or places for seat belts, which is a physical and clear matter which can be tested, and human conduct, social habits and custom. The two are different. One can be measured exactly and the other is local.
I agree with genuine co-operation on standards, particularly on safety matters, but in matters of human conduct, where compliance is subtle, deterrence is important. My hon. Friend the Member for Lewisham, Deptford (Ms. Ruddock) illustrated that in her remarks on random breath testing.
We all know that compliance, deterrence, penalties, sentencing policy and the way in which police operate are sensitive matters even in different parts of our own land. Therefore, it is fundamental that we should leave this to a level where there will be the best practical result. The evidence given by the hon. Member for Eltham (Mr. Bottomley) to the Committee was strong in that respect.
However, the evidence given to the Select Committee on competence was not reassuring. One of the Commission's witnesses appeared before the Committee and the Chairman asked:
I am wondering if you could indicate to us, on your interpretation of the Treaty, what you would regard as being appropriate for a national government or parliament as legislation within the sphere of transport? As you have explained it, one would assume that there was none. Am I right in that?
The reply was ambiguous and at question 44 the Chairman again said:
As you have answered that, it would appear to us that as transport is clearly an economic activity, nothing would be excluded. I am not sure whether you would agree with that?
Mr. Gosalbo-Bono replied:
Legally speaking, according to the Treaty of Rome, every possible subject that will come in the field of transport—there will need again to be established a common transport policy—will fall inside the competence of the Community.
That was the view of the legal officer to the Commission's Director General of Transport. It is not necessarily that of the European Court, but that is clearly the case that the Commission would argue if it ever got there.
I would have hoped, along with the hon. Member for Hertford and Stortford, that common sense would intervene. Irrespective of whether it is a good thing or not, and even if it could be proved that it was within the competence of the treaty, surely any wise Government would not push legislation to the limits of its own constitution. Some Governments may do that. Some politicians, even some Prime Ministers, may do that. But whether that is wise is a different matter.
I hope that Ministers will argue that, irrespective of whether there is competence—the Commission thinks that there is, but Ministers think not—it would be unwise to use it in this respect. That would be in accordance with good human nature and so would be more likely to yield the practical results that we all wish to see.

Mr. Roger King: I listened with interest to right hon. and hon. Members in all parts of the House, and agree with my hon. Friend the Member for Southend, East (Mr. Taylor) in his criticism of the European Community inflicting ideas and legislation on this country. However, in respect of motor transport policy and of motor vehicle construction and usage, it may be to our advantage to arrive at a consensus throughout the Community, in establishing a legal framework within which all member states could operate. The opening of the


Channel tunnel and the broadening of Europe's motoring horizons will bring a far higher number of heavy goods vehicles on to our roads. Some commonality of speed limits, driving hours and usage would only be sensible.
We must ensure that the message goes from this House that the Commission's proposals are unacceptable as they stand. Annex 1 to the Committee's report shows the percentage distribution of blood alcohol concentration across a sample of 728 road accident fatalities. Thirty-five per cent. of fatalities occurred among drivers having an alcohol level of 0·09 per cent. in their bloodstream. That is a tiny limit, and one wonders whether the accidents could be blamed on other factors or were wholly attributable to the drivers concerned being in a highly inebriated condition. The same question arises in respect of the 29 per cent. of the sample having an alcohol concentration of 0·5 per cent.
The majority of accidents occur among drivers having an alcohol level of 0·8 per cent. and above. Our limit is 89 mg of alcohol per 100 ml of blood, and experience over many years shows that most fatalities occur among drivers with an alcohol concentration well in excess of that limit. We should try to ensure that the standard adopted throughout Europe is that which the majority of member states already apply.
Much greater controversy surrounds speed limits. British road conditions, widths, signposting and other variables make it difficult to apply to our motorways the limits that are imposed elsewhere in Europe, and the reverse is true in respect of German autobahns. British roads consisting of three lanes and a generous hard shoulder may be classified as motorways, whereas two-lane roads with narrow shoulders in Germany may be designated as autobahns. Nevertheless, it is probably safer driving fast on a British motorway than it is on an autostrada—even though the motorway has a higher speed limit. It would be difficult to establish a pan-European speed limit for motorways.
Nevertheless, a European scale of speed limits seems sensible as we move gradually towards a more integrated Europe. The 30 or 31 mph limit exemplifies the ludicrousness of some of the proposals: what we mean is that we will stick to 30 mph, and if the rest of Europe wants to do 31 mph who is going to argue? Surely it is not necessary to insist on a 30 mph limit if the rest of Europe can accept 31 mph, because of the difficulties involved in translating metric speeds into miles per hour.
The hon. Member for Lewisham, Deptford (Ms. Ruddock) discussed proposals for heavy goods vehicles and coaches. The European requirement that coaches should he restricted to 62 mph on motorways is clearly ludicrous; there is no evidence to suggest that that is much safer than our standard 70 mph limit. Coach travel—which many people have had an opportunity to sample as a result of the rail strike—has become more popular since deregulation, and there is no evidence that passengers travelling at 70 mph on the top deck of a Rapide coach are frightened out of their wits. On the contrary, drivers on the M1 passing Scottish Citylink coaches on their way to Glasgow in the late evening will see the passengers sound asleep, or perhaps watching a video, at speeds at and over 65 mph.
I am also appalled at the suggestion that expressway vehicles—whatever they are—should be limited to 50 mph. We would certainly wish to contest such a restriction. I note from the requirements that coaches will be traveling

at, or very near, the same speed as heavy goods vehicles. The present speed limit for coaches makes a good deal of sense, and experience has suggested that coach travel is extremely safe.
Perhaps the European Commission should have a look at our railways: some of the trains do not seem to hold the track nowadays, as we have seen recently. I doubt whether they will get round to it, however, as far too many environmental lobbies favour rail transport and are constantly seeking to place more restrictions on motor vehicles and travel.
We are lucky in this country: because of our attitude to coach travel we have built up a very popular system, which enables passengers to journey from one end to the other at an economic price. That is not possible in Europe. because coaches travelling at 50 or 60 mph cover ground so slowly that it is not an attractive form of transport. If we wish to retain the competitive nature of our transport—road versus rail versus air—we must ensure that all modes of travel are encouraged in the right way. I favour a limit of 75 mph for cars, with higher speeds for quieter motorways.
Let us consider the legislation carefully: we need to get matters exactly right.

Mr. Portillo: I welcome the generous remarks made by the hon. Member for Lewisham, Deptford (Ms. Ruddock) about my hon. Friend the Member for Eltham (Mr. Bottomley): he put his heart into his efforts to improve road safety, and I believe that he has a good deal of achievement to his credit. I also welcome the many points that she made in agreement with the Government's position, as set out by me. I shall, however, study with great interest what she said about giving support for good ideas, whatever their source. My hon. Friend the Member for Southend, East (Mr. Taylor) responded quickly to that feature of her speech.
My hon. Friend the Member for Southend, East also asked me why I had not mentioned minibus driver licensing. The answer is that it is not included in the documents that we are discussing. I refer my hon. Friend to a written answer given by my hon. Friend the Member for Eltham on 21 July 1989, in which he said that he had made good progress in direct discussions with the Commission about minibuses. He thought that the Commission's proposals on the second driver licensing directive could be modified to allow ordinary car licence holders, including the deaf, to drive minibuses with up to 17 seats under wide-ranging circumstances, which are set out in the written answer. Obviously, at this stage, the modifications are only proposed, but the discussions have been highly encouraging. I thank my hon. Friend and other hon. Members for the support that they have given the Government, which has been instrumental in persuading Community officials that they should suggest such a compromise.
My hon. Friend the Member for Southend, East (Mr. Taylor) referred to speed limits. It is clear that the Commission has not thought sufficiently about the practical implications of harmonising speed limits or, in particular, the cost of harmonising speed limits or, in particular, the cost of conversion. We robustly pointed out the difficulties to the Commission. Opposition to harmonisation of speed limits among other member countries is so firm that so far no attempt has been made


to begin Council negotiations. Derogation does not arise because there is no community law on speed limits. It is clear that harmonisation will not be pressed, because, if it were, ludicrous consequences would result. I am happy to assure my hon. Friend the Member for Southend, East that we would be prepared to go to the European Court if necessary, but a strong issue would have to be involved.
The hon. Member for Newham, South (Mr. Spearing) said that it is not sensible to try to legislate Europewide on local custom or human behaviour. I believe that we have used that argument in the past, but I am happy to endorse the hon. Gentleman's remarks.
My hon. Friend the Member for Hertford and Stortford (Mr. Wells) stressed subsidiarity, and I agree that we should press that important principle. We should like it to be applied in the United Kingdom as well as in the European Community. We depend on local authorities for much of the good work that is done.
The principle underlying our approach to road safety is that we should concentrate on measures on which we can be reasonably sure that our proposals will reduce casualties. Many questions have been asked about whether the Community has competence to deal with this matter. We doubt whether some of its proposals meet the test of having been proven to improve road safety——

It being one and a half hours after the commencement of proceedings on the motion, MADAM DEPUTY SPEAKER put the Question, pursuant to Standing Order No. 14 (Exempted Business).

Question agreed to.

Resolved,
That this House takes note of European Community Documents Nos. 4303/89 on seat belts, 4252/89 on road safety, 9228/89 on maximum permitted alcohol concentration for vehicle drivers, and 4156/87 and 4305/89 on speed limits; and endorses the Government's commitment to resist proposals in this area which are outside the field of Community competence, and not clearly related to the objectives of a common transport policy or of the internal market.

Freedom of Movement

Madam Deputy Speaker (Miss Betty Boothroyd): I must inform the House that Mr. Speaker has not selected the amendment in the name of the hon. Member for Thanet, South (Mr. Aitken).

The Parliamentary Under-Secretary of State for Employment (Mr. Patrick Nicholls): I beg to move,
That this House takes note of European Community Document No. 5786/89 relating to freedom of movement for workers; supports the broad objective of free movement for workers within the Single Market; and endorses the Government's intention of seeking amendment of inappropriate provisions.
The Commission's proposals aim to amend the basic Community law on the free movement of workers which was established more than 20 years ago. We adopted the principle of free movement when we joined the Community and continue to support it as an essential element of the free market. The right of a national of any member state to take or seek work throughout the Community gives everyone a stake in the success of the free market.
The existing rules have provided that right for 20 years. They also require workers from other member states to be treated equally to nationals of the host state, and allow them to be accompanied by their immediate family dependants of any nationality. The Commission now proposes to amend and extend those rules. The proposals are at an early stage and we are seeking the views of the House before they come to be discussed in the Council of Ministers.
However, it is already clear that a number of member states, including ourselves, would have difficulty accepting all the proposals as they currently stand. The proposals are detailed and technical, but they also contain some general principles the effects of which are far from clear. It seems that in some respects they go beyond what is appropriate to the free movement of workers and that they raise some questions about Community competence on the admission of people who are not themselves nationals of member states.

Mr. Tony Marlow: I hope that I am in order in harking back to the previous debate. The theme running through that debate was concerned with Community competence, and the Government said that what the Community was trying to do was not within its competence. My hon. Friend is saying that on the important matter that is now before the House, which touches the basis of statehood—immigration—he believes that the Community does not have competence.
I ask my hon. Friend the question that was asked in the previous debate. Supposing that the Community gains competence by the use of these measures, uses the European Court and uses the majority voting procedures that are available to it. What then will the Government do? The Government know well that the British people would regret, would resent and would be totally against the Community gaining competence over immigration measures. What would the Government do? We need to know the answer.

Mr.Nicholls: As I said when I gave way to my hon,.Friend, ther is a question of competence here, Although


this is a wide-ranging proposed regulation, the Government take the view that in one respect at least the question of competence is not made out, and that relates to what is proposed as regards those members of a family who are non-EC nationals. The question of competence is whether the Community is competent to make regulations or directives about non-EC nationals. The Government take the view that the right way to approach the issue is to try to negotiate it in the usual way, and to make sure that the Community is confined so that it deals with matters of competence, because, as my hon. Friend knows——

Mr. Marlow: rose——

Mr. Nicholls: —or he would not make the intervention that I suspect he is about to make—there is no way in which competence can be challenged before the event. One cannot go to the court and say, "Here is a measure which, if it were to be made, would be ultra vires." If, at the end of the day, the directive or regulation is made and it is alleged that it is ultra vires—because the Community was incompetent—that could be challenged before the court, but that is a long way down the road. Obviously, the correct procedure is to negotiate, and take the view of the House at an early stage, to make sure that the Community confines itself.

Mr. Marlow: As my hon. Friend looks at this issue—an individual issue—in prospect, that might be right. But we have had examples in the past where the Government fought Community competence and that competence was established, and measures which the Government did not like were passed. Once a directive or regulation is in, even if it is challenged, it is the law of the land until the court overthrows it. So one is saddled with Community legislation until the court overthrows it.
The court, as my hon. Friend the Member for Stafford (Mr. Cash) said in an earlier intervention, is a political court, biased towards Community competence. Time and again the Government have been defeated, and it is becoming an accelerating process; the Government are more and more being defeated over Community competence. When will the Government do something about that? We are being rolled over and we do not like it.

Mr. Nicholls: I have been accused of many things, but never of rolling over my hon. Friend, and I would like to think that tonight will be no such occasion. My hon. Friend just made an interesting and telling intervention in which he set out again his views on qualified majority voting. He has his views on that and he expresses them with his usual moderation and eloquence. But with respect to him, that is not the point with which we are dealing tonight.
Whether or not my hon. Friend likes it, the Single European Act is a fact. It allows for qualified majority voting, a subject to which I shall return. It is not a question of a one-way street, and we acceded to the Single European Act because, candidly, we reckoned that there was something in it for us. To that extent, the Government are prepared to take the rough with the smooth. My hon. Friend wants to take the smooth with the smooth, and I am afraid that in an imperfect world that option is not available to him.
The Commission has looked carefully at the experience over the past 20 years and at relevant judgments of the

European Court of Justice, and it has proposed a number of detailed technical amendments to bring the regulation and directive up to date.
For example, the right to receive vocational training becomes a general right, not limited, as at present, to training in vocational schools. The right to equal treatment in housing is explicitly extended to cover housing finance. All this is welcome clarification, which we support.
We support, too, changes to simplify the granting of residence permits to people with the right to work.

Dr. Norman A. Godman: In paragraph 13 of an explanatory memorandum dated 5 May, the former Minister of State, Department of Employment—the right hon. Member for Northavon (Mr.Cope) —said:
There is a widely shared concern that as drafted the proposals are much too uncertain in their effects and that in some areas they go beyond the reasonable scope of Article 49 … into areas concerned with the freedom of movement of persons generally.
Given the comments of the hon. Member for Northampton, North (Mr. Marlow) and this imprecision, do not these proposals conflict directly with section 14 of the Merchant Shipping Act 1988? It was designed specifically to exclude 95 Spanish fishing vessels from fishing in contravention of United Kingdom quotas. Do not these proposals confound not only the Merchant Shipping Act but the ruling of the other place in favour of the Government? Are we not seeing, once again, a diminution of parliamentary sovereignty and an increase in the power of the European Commission?

Mr. Nicholls: I hope that the hon. Gentleman will accept that, tempting though it may be, I shall not pass an opinion on whether the Merchant Shipping Act begs that interpretation. However, I agree wholeheartedly with the more important part of his remarks when he said that there was some imprecision in the language of the regulations. As I said in my opening remarks, we want to hear what the House has to say. I do not disguise the fact that the language is imprecise. Not only the United Kingdom but other member states want the legislation to be much tighter. You would probably restrain me, Madam Deputy Speaker, if I tried to use all the available lime to make out a case against some of the imprecise language. We are considering this matter at an early stage so that we can ventilate our anxieties and highlight the possible advantages. We want to ensure at an early stage that we do whatever we can to tighten the language.

Mr. Teddy Taylor: My hon. Friend has kindly said that he wants the views of the House, so will he say whether the Government believe that this proposal, which would give non-community nationals right of access to this country, is a matter for majority voting or for unanimity? It would help the House a great deal if my hon. Friend said that the Government believe that this is a matter for majority voting.

Mr. Nicholls: I have said in the main part of my speech and in responding to the interventions of my hon. Friend the Member for Northampton, North (Mr. Marlow) that the question of competence comes into this. If the EC purports to deal with the rights that may attach to non-EC nationals, there is—to put it at its most neutral—an argument about competence. We are taking that argument


back to Europe. That is one factor that will come out of this debate, and I make no apology for saying that. After all, I raised this matter in the earlier part of my speech. I concede that the question of competence is directly relevant.

Mr. Teddy Taylor: What about majority voting?

Mr. Nicholls: The Government believe that this is a case in which majority voting will apply.

Mr. Taylor: I thank my hon. Friend very much.

Mr. Nicholls: In case my hon. Friend attaches more importance to that than he might otherwise do, let me say that that is how it seems to us at this stage. It remains to be seen whether that remains the position in the light of events.
We and other member states have said that these proposals cannot be agreed as they stand without looking further at the effects that they might have and seeing whether they should be considered under that part of the treaty that deals with the free movement of workers.
First, the current regulation gives the right of free movement to the worker's spouse and dependent children of parents. That is quite right, and clearly has a bearing on whether the worker will feel able to move to another member state. The Commission proposes to extend those rights to cover relatives who may or may not be dependent. This includes people who may not be nationals of member states. The Commission has not attempted to define the scope of the further family members concerned, other than that they are dependent on the worker or live under the same roof. We are concerned that this could include remote relations who have little to do with the worker. The worker's ability to move and take work is not influenced by whether he can take these family members with him. In our view, those people should not be covered by a Community instrument on rights of workers because their movement is not necessarily connected with that of the worker.
Giving the right to enter and move within the Community to more distant relatives or to ex-husbands and ex-wives would be difficult to control. It would make the job of deciding who had such rights very difficult and could lead to false claims to free movement rights from non-Community nationals. If such people are to be given the independent right to free movement, this should be in the context of general rights of residence, on which the Commission has other proposals, not in the context of free movement of workers. The Commission has other current proposals on rights of residence, but as they stand they would not deal with the rights of the remote relatives of workers whom I have mentioned. That is no reason why the issue should be dealt with in these proposals on the movement of workers.
The second difficulty is the proposed general principle that anything that happened in another member state should be treated as though it had happened in the state where someone is living, for the purpose of getting a tax or social advantage. That goes beyond the existing principle of equal treatment because United Kingdom citizens do not necessarily have the right to have anything that happened to them abroad taken into account to qualify for tax or other social advantages. Whether such experience is

counted will depend on what the rights in question are, which is not at all clear. Rather than agree to such a general principle without knowing the implications, we would want to examine exactly which rights and which circumstances it refers to, and ascertain whether they are acceptable on an individual basis. That might or might not be appropriate to this Community legislation.
Finally, the Commission proposals seem to imply that there would be a duty on the Governments of member states to take action to pursue any case of apparent infringement of the principle of free movement. Remedies for that already exist. Anyone who feels that he has been discriminated against can take action under the race relations legislation, or can use existing Community law which has direct application. Cases of such discrimination are extremely rare. Laying an extra duty on member states would seem to us unnecessary and over-bureaucratic.
We are keen to encourage full application of the principle of free movement—for example, by breaking down barriers caused by failure to recognise professional qualifications. Many of the Commission's proposals will be helpful, but unfortunately others seem to go beyond what is needed and cause problems because their implications are so uncertain and wide-ranging. We, and no doubt other member states, will be examining them closely to try to get them clarified and amended as necessary to ensure that the changes finally agreed will contribute to the process of completing the single market and not cause unnecessary difficulties and uncertainties.
I repeat that the Government are interested in hearing the views of the House on this matter. It is clear from the amendment that hon. Members share our concerns about the wide issues that the Commission intends to cover in this measure. The proposals are in the early stages of negotiation and we believe that the best way forward is to deal with the concerns that are highlighted by the amendment during the negotiation process and by identifying other member states that share our concerns. We can welcome in general, and do, the principle of updating rights for the free movement of workers in preparation for the single market, and therefore we cannot accept the amendment. I assure the House that the underlying sentence in the amendment is something with which we have a great deal of sympathy, but we believe that the way of taking forward the concerns expressed lies very much in negotiation.

Mr. Tony Lloyd: When the Minister replies to the debate, I hope that he will expand on his final comment. He said that he has a "great deal of sympathy" with "the underlying sentence in the amendment". The amendment is clear——

Madam Deputy Speaker: Order. I must make it clear to the House that Mr. Speaker has not selected the amendment and that therefore it is not under consideration.

Mr. Lloyd: I accept what you are saying, Madam Deputy Speaker, but it is fair to point out that the debate covers such matters as the majority——

Madam Deputy Speaker: Order. I have made clear what we are debating.

Mr. Lloyd: That the Minister should tell the House that he has considerable sympathy with the underlying view that the majority voting system is wrong will be news to the Prime Minister. Hon. Members on both sides of the House will remember that she was instrumental in dragooning the necessary legislation through the House against the will of the bulk of hon. Members on the Government Benches.
I also point out to the Minister that when his hon. Friend the Member for Northampton, North (Mr. Marlow) created a mini-debate earlier, he raised the important issue of where we stood on the issue of majority voting. It is clear that, in the case of freedom of movement, the Government are not in a position one way or the other to decide what will happen, because the decision for that has passed from the hands of the British Government into the domain of majority voting in the rest of the European Community.
Whether the Government like it or not, the Prime Minister, in fairly unequivocal terms, gave a commitment when she described freedom of movement. That is one of a number of legs on which Mr. Delors' "infamous" social charter stands. The Prime Minister made it clear that the measure was to be a test case for the Court of Justice in Luxembourg. Perhaps, the Minister can tell us how that test case will be instituted, because it is clear that no test case will be possible unless the Government are able to bring freedom of movement outside the majority voting system. I do not believe that they will be able to do that.
It is fair, too, that I should point out that freedom of movement is part of what the Prime Minister described as the Marxist interventionism into which the Commission is now leading us. That is the point at which the Labour party clearly will draw the line and say that we will go no further with the Government. The Government are becoming increasingly isolated in their views on the need for some form of social charter for employment rights. Whether we accept it or not, the Government have put themselves and the nation into the position of having to accept that many parts of the social charter will be implemented by the majority voting system. It will be interesting if the Minister could tell us what other parts of the social charter will be implemented by the majority vote and whether it is the Prime Minister's intention to go to the Court of Justice. If it is her intention, what parts of the social charter will she challenge?
The most disappointing aspect of the Minister's speech was what it did not say about the Government's views on, and attitudes towards the social charter generally and the particular aspect of freedom of movement. The Minister did not say that the freedom of movement of workers must be considered in the context of the rest of the social programme that the European Commission has proposed. If we have only the narrow interpretation of the freedom of movement put forward by the Minister, where he welcomes, for example, as we do, some movement towards ratification of common qualifications, of course we accept that. If the Minister is, however, seriously saying that the only important aspect of freedom of movement concerns such things, he is taking a very mechanistic and economic view of the arguments.
It is significant that when, in January, the Chancellor made his speech about freedoms, while he was prepared to talk about freedom of capital and other freedoms, the one that he left off his list, importantly, was the freedom of movement, of workers, because that did not play any significant part in the Government's thinking. The

Government must accept freedom of movement of workers, because that was enshrined within the treaty when Britain acceded to it.
There is no going back on the principle of freedom of movement. I am sorry that the Minister seems prepared to skirt around and perhaps to pander to the more unpleasant aspects of the Government's opposition to the freedom of movement, because we know that it would bring Britain's immigration laws into conflict with the European Community.
As one whose constituents suffer considerably from the impact of such laws, I would have to welcome anything that forced an easing of that problem. We have the ludicrous position where, on marriage, my constituents can take their spouses into any other city in Europe—as long as it is not one in the United Kingdom—where they can live under Community law with their spouses, but they cannot bring those same spouses into this country. I find it not only ridiculous but disgraceful that my constituents can be treated in this way by the Government. It is just as disgraceful that the Minister has skirted round that issue tonight and that he is not prepared to address it straight on. That is, in effect, what the Government are saying.

Mr. Marlow: Is the hon. Gentleman saying that he would like to see much higher levels of immigration, and is that the view of his constituents?

Mr. Lloyd: No, what I am saying is quite clear. Like the European Community, I believe—as the Government claim to believe—that there should be a right for spouses of British nationals to join their husband or wife in this country. That is a principle that the Government claim to believe and a principle that the hon. Gentleman, who supports the Government, obviously accepted when he stood for election as a Conservative Member of Parliament. There is nothing unique about that, except for the fact that the Government dishonourably and dishonestly pretend that that is what they stand for, when they are administering the system in a way that makes that impossible. That is outrageous.
I want my constituents to be able to be joined by their spouses, irrespective of where they come from—be it Italy, Wales or, as it happens, from India, Pakistan or anywhere else. I hope that establishes my point clearly. There should be that right. Indeed, it is accepted in both Community and in British legislation. In principle, the United Kingdom says that it supports that right, but in practice the Minister skirts round the fact that the Government are afraid that they will lose the power to keep people out of this country by administrative means, generally on the ground that they are black, which I believe is the hon. Gentleman's position—and it is one with which I have no sympathy.
When freedom of movement and the other issues in the social charter came to the fore earlier this year, it was significant that the Secretary of State for Employment, when speaking to the other European Community Ministers, was isolated when he said:
It is seriously misleading to draw a sharp distinction between what is in the interests of business and what is in the interests of citizens.
I fully concur with that, although I do not concur with his conclusion that we do not need any social legislation or assistance for the work force. The Minister has made it clear again tonight that he has less sympathy with the aspects of freedom of movement for workers that provide


social support or other things to make the life of individual workers easier and that allow them to transfer the benefits of one country to another. In wanting to withdraw from that social debate, the Government are not only completely out of step with public opinion in this country, as was amply demonstrated in the European elections, but they have made themselves almost totally isolated among other European Community countries. The vote on the social charter in the meeting of the heads of state in Spain was 10:1, with only Denmark abstaining for a technical reason, not because it was hostile to the proposals.
The British Government do not just stand alone within the member nations, the British Government and British employers stand almost alone in all European opinion on this matter. When the economic and social committee was asked to look at the social charter, the vote in favour of proceeding along those lines managed to unite the bulk of business opinion throughout Europe and the bulk of trade union opinion throughout Europe. We also had the odd position of British employers being in alliance with the French Communist trade unions as the only groups opposing the social charter. The Minister may derive some satisfaction from the fact that the Government are in that uncomfortable alliance with the French Communist-led trade unions. The Minister may glory in that isolation, but he and his colleagues appear not only isolated but foolish in the eyes of Europe.
If the Minister is prepared to accept the freedom of movement of workers as they move around Europe in the interests of the freedom of capital, but does not recognise that the bulk of opinion in Britain and throughout Europe is that that freedom of movement can exist only with the rest of the social charter, with protection for workers in Britain and throughout Europe, his vision of Europe is so barren and irrelevant to the long-term needs of Britain and the rest of Europe that it will be rejected, as it was rejected by the electorate in the European elections.
The Minister and his colleagues talk about a Britain based on the principle of a low-wage economy where capital will magically appear. But we will end up with the branch-plant economy that has bedevilled British economic history for the past 10 years. We know that Ford in Europe regards Britain as a low-paid, low-tech economy and prefers to locate high-tech production and investment in West Germany, which has higher labour costs but higher levels of skills. The Minister must accept that the future without the social charter puts Britain in the low-tech, no-tech league with low pay and not much future as we head into Europe.
That is why the Opposition believe that the future is clearly with the social charter. We understand why the Prime Minister described the social charter as a piece of European Socialism. If the Minister and his colleagues care to read the Labour party's policy review, they will find that many of the better features of the social charter run parallel to the views expressed in that document. That would not appeal to the Prime Minister or to the Minister because they know that the tide of public opinion in Britain and throughout Europe is moving to that view of the future—a Europe where people in employment are offered not only the spurious employment rights that the Government claim they have, but proper protection.

Mr. Marlow: Perhaps the hon. Gentleman, if there is one, could tell the House his limit and the Labour party's limit as to the level of competence the European Community should have over social policy. Should they decide on social security benefit levels or on housing? Where should it stop? We have heard one speech already from the Labour Front Bench which says that Europe ought to have competence where it has good ideas. Where does the hon. Gentleman feel, if there should be a limit, that limit should be with regard to European competence?

Mr. Lloyd: It is only fair that I point out to the hon. Gentleman that the Labour party's views on the Single European Act were quite consistent. It was not a Labour Government that forced that Act through Parliament. The hon. Gentleman will remember that the Labour party made its position quite clear at the time.

Mr. Marlow: How many opposed it on Third reading?

Mr. Lloyd: The hon. Gentleman will also know the Government's position at the time. He supports the Government. He may care to rebel against them at moments of pique and angst, but he keeps them in power, and has done so for some years now. On that basis the hon. Gentleman does not have much credibility. It is one thing to talk about rebellions and grand gestures, but the serious politics of the European Community is an entirely different matter. He has been prepared to sustain the Government in power so that they could give away those rights under the majority voting system.
The hon. Gentleman has to accept that fact. He has been part of the process that has given the Commission considerable control over the decision-making of this House. He will know that most social policy and some employment rights are not subject to the majority voting system. We are where the Government have put us. That is what we are debating.
Which parts of the social charter do the Government think they will be able to take to the European Court of Justice? The Prime Minister is on record as saying that she will go to that court, but it would be helpful to know what aspects of the charter are preventable on that basis and what aspects the Government have already given up the right to oppose. Their crass and pig-headed operations in Europe guarantee that they will not be listened to in any debates on improvements or amendments to this document.

Mr. Marlow: Will the hon. Gentleman now answer my question? What level of competence should the European Community have over social policy? What is his view and that of the Labour party on that? How far should it go?

Mr. Lloyd: The hon. Gentleman is asking a question that has no relevance, because the Government have already sold the pass in areas where majority voting applies. There is nothing that a Labour Government can do to withdraw it. Where majority voting might be extended is not an issue.
The Labour party will be fully supportive of the European Community in efforts to bring in a social charter that guarantees people's rights to be members of trade unions—unlike the Government, who have tried to prevent that. Labour will support a social charter where it enhances social benefits and brings uniformity of pensions, and increases pensions. Britain is the poor pensioner nation of Europe. Labour will support a social charter


where it enhances benefit rights, and where it enhances people's rights at the workplace in terms of health and safety. The Government fight shy of and run away from all of those things because of their misguided view of Britain as a low-wage and, they claim, high employment economy. In fact, it is an increasingly vulnerable economy as it depends on the whims of outmoded technology and employment practices. Theirs is a future which simply does not work.
The Minister made a narrow and fairly technical speech about freedom of movement. He has not answered the broader questions about why the Government oppose parts of this document. I suggest that the reason lies in the Government's desire to protect our rather nasty immigration rules. To discuss the freedom of movement of workers without the wider context of the social charter is simply to misunderstand why there is value in freedom of movement from the point of view of employees. I hope that he will put his mind to the serious issues that are raised in the document.

Mr. William Cash: This is an open-ended provision. There seems to be no limit to the number of people who can come in or to the benefits that they can seek. It strikes me that it is extremely peculiar that, at this late hour, we are discussing something which should never have seen the light of day in its present form.
Why is the Commission given the opportunity by member states to make proposals that are so open-ended, when it would be far more sensible to retrench its powers by giving greater powers to the Council of Ministers? I concede that that would have to be done by way of treaty amendment, but in the light of the Single European Act, it seems highly desirable. I have said repeatedly that I am not, in principle, against the Single European Act. I voted for it and I have said that I would do so again. However, a fundamental difference has occurred since the passing of the Act.
Before the Act, proposals such as the one we are discussing tonight could be justified in terms of their being produced and drafted by the Commission, because there had to be an on-going negotiating process with the Commission as part and parcel of the watchdog apparatus of the treaty of Rome. Now that we have the Single European Act and far more majority voting, I cannot see why we cannot have a treaty amendment, the effect of which would be to give greater power to the Council of Ministers. However, the time is coming—particularly in the run-up to the intergovernmental conference and in the context of matters such as extensions of the economic and monetary union—when we should look seriously at the other side of the coin—amendment of the treaty. The aim would he not to get away from the benefits of the Community, but to put on a more sensible basis the manner in which legislation emanates from the Community.
The power of the pen—that is, the power of the Commission—to produce proposals such as this is so open-ended that there seems to be no limit to the extent to which it can come forward with proposals which then inevitably end up either having to be cut back as a result of meetings of working groups behind closed doors, or in the European Court of Justice itself. Most of these matters could be resolved at a far earlier stage.
I hope that we are also about to improve the procedures in this House for dealing with the scrutiny of European legislation. This is not an airy-fairy, ivory tower exercise, but the serious business of trying to make Community legislation relevant to the electorates of the member states. Can we not examine the way in which legislation is produced and prevent it from being so open-ended? We should do what we can to ensure that greater clarity is obtained in the documents at an earlier stage. I have a suspicion—which I cannot prove—that there is sometimes an intention to produce grey areas and ambiguities in Community legislation, precisely because there are those who are conscious of the fact that it is bound, therefore, to end up in the Court of Justice.
The hon. Member for Stretford (Mr. Lloyd) talked about the social charter. If one examines the provisions of the Single European Act, as opposed to the original provisions of the treaty of Rome, in the area of competence to deal with matters relevant to the social charter, one sees that they are riddled with grey areas and ambiguities. The opportunity to clarify these matters was when the Single European Act was negotiated. Instead, we have been put in a position where we can guarantee that proposals will go to the Court of Justice. As I said in an intervention on the previous directive, we are then in the unhappy position of knowing that, because of the tendency in the Court of Justice towards political integration, it will interpret the proposals in favour of ghat objective at the expense of the rather more narrow and specific approach that would be taken in this country.
As the bottom line, I am talking about democracy. I have constituents in Stafford, as the hon. Member for Stretford and all other hon. Members have constituents, who will be affected by the proposals. We have an absolute right to require that the basis upon which the documents are prepared in the first place are far clearer before they reach us. The Council of Ministers should seize the opportunity, in the run-up to the intergovernmental conference, to try to identify ways and means of ensuring that documents come before us and the Council of Ministers on a far clearer and more specific footing.

Mr. James Wallace: I support the call for clarity by the hon. Member for Stafford (Mr. Cash). No regulation or directive does anyone any good if there are large grey areas in it. The Minister referred to the Government entertaining some doubts about the part of the measure that relates to enjoying certain social services in other countries. I do not think that hon. Members have much idea of what we would be letting ourselves in for if that point were to go forward. To that extent, greater clarity would be welcomed.
My right hon. and hon. Friends and I believe in the concept of freedom of movement throughout the European Community, not least for those in employment. That matter is at the heart of what we are considering. We would like the European Community to be more than an economic club—one that actually impinges on all aspects of people's lives and gives them a greater opportunity to exercise freedom of movement throughout the Community.
At present, only 4·8 million European Community nationals live in other European Community states—in other words, in a state other than their own national state


—which, at one point, was 5 per cent. of the total European Community population. That is far lower than the degree of internal migration in the United States of America, for example.
Certain aspects of the measure will help to reduce some of the barriers that otherwise operate against freedom of movement. For example, equal treatment in housing loans and grants is important, and we should welcome it. Other things could be done. I welcome what the Minister said about reducing the barriers that result from different professional qualifications. We could look to allowing workers to transfer private pension rights across frontiers and to giving migrants free access to job agencies. They would be positive developments.
I cannot accept what the hon. Member for Stafford said about this proposal being an open-ended commitment to all and sundry to move between countries X and Y in the Community. If the hon. Gentleman looks carefully at the words of the motion, he will see that that is not the case. It is confined to people in the ascending line and to descendants. We must look at the issue in practical terms. Of course, descendants could theoretically be a larger number. Ascendants are restricted to parents, parents-inlaw, grandparents, and grandparents-in-law. It is unlikely that great-grandparents would want to move.
One thinks of what happens within the United Kingdom. Families often move from what has been the family home, and couples often move with their children. It is probably more the rule than the exception that the whole family moves—grandparents, great-grandparents, the lot. When my wife and I set up home in Orkney, I do not think that either set of parents thought of moving with us. They had their own lives and occupations in places where they had been for a long time. We are not necessarily opening the doors for a great influx or efflux of people. There might be circumstances in which, for reasons that fall short of dependency, a close, integrated family, including the grandparents and the children who are not necessarily dependent, would want to move to another part of the European Community.
Those of us who have a slightly greater vision of the European Community than one confined to business purposes see nothing wrong with families being able to move and stay together. Other parties may genuinely support the concept of the family and would be prepared to accept that there are circumstances in which non-dependent children and grandparents may wish to move with the family. It would not lead to a great number of people going to and fro, but it might prove a worthwhile provision in certain family circumstances.

Dr. Godman: Does the hon. Gentleman agree that there is some ambiguity about the proposals as they were outlined by the then Minister of State on 5 May? He said that they shaded into
areas concerned with the free movement of persons generally.
Does not such ambiguity give some comfort to the Spanish quota hoppers?

Mr. Wallace: I do not think that there is ambiguity, because the definition of who is and who is not covered is quite clear. There is no reason why that should not be

extended to non-Community nationals. It is a fine dividing line if a worker's grandchild happens to be Austrian or Swiss rather than West German or Italian.
The position of Spanish quota hoppers is different from that envisaged in the proposals. The whole concept of fisheries quotas could be said to be contrary to the concept of the internal market. The quotas exist for good reasons, which I am sure are fully understood on both sides of the House. The Commission was wrong to challenge what we did, with all-party support, in the Merchant Shipping Act 1988 and to try to impose rules that might be generally applicable for the purpose of achieving a single market, but are not relevant or applicable under a system for fisheries, set up by the Community, that allows for national preference and does not accept a common market.
It might have been wise had the Government—they may yet do so—told the Commission that we were trying to preserve the integrity of the national quotas that had been accepted by the Commission. The whole Community should accept that. The legislation is a step towards ensuring that what the Community has agreed as proper for fisheries is implemented. Until the Commission can come up with a better means of doing that, within its rules, it should not challenge us for trying to uphold the quotas. The onus should be put on the Commission to find a way to deal with quota hopping, which actually flies in the face of what the Commission tried to achieve when it established fisheries quotas and total allowable catches.
The proposals allow divorced spouses, widowers and widows to remain in a country after a marriage has broken down or a spouse has died. If a Portuguese person has settled in Spain, or a Spanish person in the United Kingdom, it is humane to allow them to remain following the death of a spouse and not immediately or after a short time to lose their residency qualifications.
I want to emphasise what the hon. ember for Stretford (Mr. Lloyd) said about the importance of the social charter in ensuring that what we are trying to achieve is not just a business men's club but something that actually affects people. The Government, and Britain as a whole, could lose out if it is perceived that other European Community countries have better rights for employees. We could be in danger of losing some of our best-equipped and skilled people if there are better opportunities in other countries. If the prospect of employee rights is better in Bonn than it is in Birmingham, our skilled workers might take employment in Bonn, which would be our loss. To see a narrow advantage in having lower standards, hopefully to attract capital, is short-termism at its worst.
The Government would do well to look at popular opinion. The Euro-barometer survey reported by the Financial Times earlier this month confirmed that three out of four Europeans regard the social charter as a good thing and welcome uninhibited movement across internal borders. That is one of the advantages that ordinary people perceive from greater European integration. It happens readily in the United States. No one there stops to think about moving from Florida to California to North Dakota. That could be achieved in Europe, and we must progress towards it. It does not imply moving to a united states of Europe, as I understand is feared in other parts of the House. Ordinary people would see European integration coming closer to reality, and we support the general thrust of the document.

Mr. Tony Marlow: I apologise profusely for taking up the time of the House at this late hour, but is it appropriate that such important issues are regularly debated at such a late hour in such a thinly attended House? The two European Community matters that we have debated tonight are pregnant with great relevance for national competence and national sovereignty and have a great potential impact on the British people, how they are governed and the laws by which they are governed.
I was fascinated by the speech by the hon. Member for Stretford (Mr. Lloyd). He complained at great length about the way in which the Government railroaded the Single European Act through the House. One would have thought from that that he was vehemently opposed to it, but no. He effectively went on to say that he hoped that before long the Community would take over the running of the United Kingdom's social security budget. I may be thought to be traducing the hon. Gentleman for saying this, but he also seemed to imply that he hoped that the Community would take over the running of British immigration law. He did not go quite that far, but in certain respects he implied that, if the Community gained competence over some aspects of our immigration law.
We now know that the Labour party wants to surrender control of our social security budget and our immigration laws because it believes that the unelected undemocratic Brussels bureacrats, the Commissioners at Brussels, are more competent to do that.
My hon. Friend the Under-Secretary of State made an eloquent and brilliant speech in opening the debate, as one would expect from a lawyer. He said that we have accepted the Single European Act. My hon. Friend knows that I voted against it, but that is irrelevant. It is the law of the land. In accepting that, we accepted majority voting. We accepted majority voting over the single market, but we did not accept majority voting over immigration policy. If my hon. Friend can show me anything whereby the Government said, or implied that they understood or anticipated, that any respect of our immigration policy would be subject to majority voting by the EC, I shall stand corrected. However, I doubt whether my hon. Friend will be able to do that.
The explanatory memorandum refers to freedom of movement for relatives. They do not have to be relatives in the ascending and descending line of the worker and spouse, but relatives who are dependent on the worker or living under the same roof. What does "dependent on the worker" mean? Could it be a nephew, or a sort of nephew, or a second nephew, or a cousin's nephew living under the same roof? We know what we in Britain mean by right of abode, but what does living under the same roof mean? Does it include someone who has come on a visit from north Africa or the Indian subcontinent who happens to stay with a relative, the nephew of a second cousin staying with a relative who has come from Morocco who is living in France, if the Moroccan who has become a French national then decides to come to Britain? Can he bring all those "nephews" with him? Is that what this regulation implies? Is that what the hon. Member for Stretford believes that his constituents want, and that they want it decided at the European level?
The hon. Member for Orkney and Shetland (Mr. Wallace) said that when he went up to live in Orkney, his

great-grandparents and the rest of his family did not necessarily want to come up with him. All right, but it is a beautiful place and they may change their minds and want to go there later. That is not really what we are talking about. If they want to go to Orkney, splendid—and if they are living in my constituency and are inclined to vote Liberal, it is a very good idea if they go up there. I put it to the hon. Member for Orkney and Shetland that that is not what we are really concerned about.
We have a problem in Europe and in the United Kingdom, in that there are vast numbers of people in the Third world who are poor—poorer than us—and, for very genuine and sensible reasons, they want to migrate. For economic reasons, they want to migrate to the rest of Europe. It is a very powerful move, and we have got to have very clever, fair, and sophisticated laws to deal with it. That has nothing to do with whether or not the hon. Gentleman's great-grandfather wants to move to Orkney. The pressures are different. The situation is wholly different, and the hon. Gentleman is not talking about what we are talking about in this debate.
The proposed regulation states:
All such people would have the same rights … arid of her social advantages generally".
What does that mean? I think that it means social policy. But if they are going to gain rights to social policy, and if the Community is going to decide on these aspects of social policy, where is it going to stop?

Mr. Matthew Taylor: At the Orkneys.

Mr. Marlow: I think that the answer to my question is that it will stop at Calais.
The regulation also states that people ought to have the right to come to this country after the dissolution of marriage. Somebody could come to this country who was from a different culture or background, who could have had several spouses in the past. All those marriages could have been dissolved five years ago, 10 years ago or 15 years ago. Where do the records exist? Is it not going to be a problem? Is it not going to be difficult? People who have never been in this country—ex-spouses—would, under the regulation, be allowed to come to our country. I think it is nonsense, and if the hon. Member for Stretford thought about it, he would agree that it is nonsense.
Paragraph 6 of the regulation states:
Member States would be required to take action to curb discrimination against those entitled to free movement.
We know that the Irish have for a long time been entitled to free movement in this country, and we do not complain about that. But there is evidence—and it is very difficult to get clear facts on this—that an Irishman in Ireland who contracts AIDS or who becomes drug-dependent will for preference, and for reasons of anonymity—and perhaps because of pressure from the Catholic Church and for reasons of better treatment—wish to come across and have his AIDS or drug dependency treatment in this country. I think that a lot of people go to the Parkside health authority.
The average AIDS treatment costs about £20,000 or £30,000. Perhaps that is something that we would want to do something about. If we accepted that
Member States would be required to take action to curb discrimination",
we would not be allowed to do anything. If somebody wanted to come here for any such reason, because the


treatment was better or because they would get a better deal in this country, they need never have been here in their lives before—never have worked in this country before.
Maybe at the moment we can do something about it, but if we allow the regulation to go through, all those things will be beyond our competence—beyond the competence of this sovereign House—to control. It would be beyond the competence of the hon. Gentleman's constituents to get their elected representative to do anything about it, because it would be outside their control.
In the text of the regulation, the Province of Northern Ireland is mentioned. We have problems of terrorism in Northern Ireland. How will the regulation, directive, ordinance, or whatever it is, from the European Council affect our right to prevent potential terrorists from going to Northern Ireland?
The legal basis is being dealt with under a qualified majority. This is pregnant with significance for our immigration policy, and it is to be dealt with by a qualified majority. If this gets through on the basis of qualified majority, it means that the whole of the immigration policy of the United Kingdom is potentially subject to be decided by qualified majority in the Council of Ministers.
I believe that when we signed up with the European Act we did not anticipate that. I believe that we did not want it, and I believe that we do not want it now. Furthermore, I believe that my hon. Friend who so eloquently opened the debate—and the rest of the House, by and large-do not want it. But if it happens—if the single majority vote forces it through—and if we then take it to the Court, which is quite likely because it is a political court, as has been said several times in the House this evening, and we are defeated, what then are the Government going to do?
Time after time, issues are put before the House; time after time, the Government say that they are reluctant; time after time, the Government say, "It is on the wrong treaty article, and it should not be by majority vote. If it does go through we will take it to the court." Time after time, these issues come to the House, are disclaimed by the House, go to the Community and are agreed by the Community—and then they are forced on British people.
We never anticipated, when we signed up with the Single European Act, that many of these things would come through. It was never explained to the British people that the Community would gain competence over these issues. We never wanted the Community to gain competence. But day by day, mile by mile, the Community is gaining competence. What are we going to do about it? That is what this debate is about; that is what the previous debate was about; and that is the answer that we want to hear from my hon. Friend in his eloquent, lawyerly way.

Dr. Norman A. Godman: The hour is late, and I promise that my speech will be brief.
According to paragraph 4 on page 16 of the document 5786/89, one objective is
strengthening the rule of equal treatment for nationals of the host State and other Community nationals".
As I said in an earlier intervention, just two months ago the former Minister of State pointed out a degree of

ambiguity in that: it seemed to deal with much more than the free movement of workers, and to drift into the sphere of free movement of persons generally.
I suggested to the hon. Member for Orkney and Shetland (Mr. Wallace) that, given their ambiguity, the proposals might provide some comfort for the owners, managers and crews of the 95 quota-hopping Spanish fishing vessels. The hon. Gentleman was absolutely right when he said that the Government's Merchant Shipping Bill—which became the Merchant Shipping Act 1988—received the undivided support of the whole House, especially what became section 14, which provided that a fishing vessel should be eligible for British registration only if it were British-owned and managed from within the United Kingdom.
Might not some of the workers defined in the somewhat ambiguous phraseology of the documents be managers of such vessels? Section 14 sought to exclude them from fishing against the United Kingdom quota. This is an important issue, because between now and the end of 1991, the United Kingdom fishing fleet must divest itself of some 35,000 gross registered tonnes. In crude terms—we can offer only a rough approximation—that might constitute between 600 and 800 vessels, and affect fishing communities from Shetland down to Cornwall.
If, however, the United Kingdom Government were to win their case in the European Court of Justice—the case will end up there—those 95 Spanish vessels might total some two thirds of the gross registered tonnage that must be shed by the United Kingdom-registered fleet in just over two years.
With the active encouragement of the Spanish Commissioner, Manuel Marin, the other Commissioners are maintaining proceedings against the United Kingdom. Despite the House of Lords ruling in support of section 14, all 17 Commissioners have said that there is a powerful case to be developed in the European Court of Justice against the Government. An important point of principle is involved, because if the Commissioners win their case will not the Government have to amend the Merchant Shipping Act? Would not section 14 be thrown into the wastepaper basket? The decision is important for the fishing communities scattered around the United Kingdom coastline.
The Commission claims that the nationality requirements in section 14 of the Merchant Shipping Act contravene article 7 of the treaty on discrimination on the ground of nationality. The Commission's imprecise proposals might strengthen its case on section 14.
The primacy of parliamentary sovereignty is an important issue. Is the Merchant Shipping Act powerful enough to withstand——

Mr. Wallace: It is an English doctrine.

Dr. Godman: From a sedentary position, the hon. Gentleman rightly says that it is an English doctrine.
We have a clash between the European Commission and English legislation. It may be two years before the European Court of Justice reaches a decision. In the meantime, what will happen to the British fishing fleet, bearing in mind all the vessels that will be stripped from it? Will the European Court of Justice instruct the Government to amend important legislation—section 14 of the Merchant Shipping Act?

Mr. Nicholls: When I opened the debate, I said that I looked forward to hon. Members' comments on the proposed regulation. I said that I expected hon. Members' comments to be helpful to the Government, and they have been.
I thoroughly enjoyed the speech made by the hon. Member for Stretford (Mr. Lloyd). How anyone can combine such genial eloquence with brazen cheek in equal measure is quite remarkable. To listen to the hon. Gentleman, one would have thought that he had spent his political life advocating the virtues of the Common Market in a way that would have made my hon. Friend the Member for Northampton, North (Mr. Marlow) apoplectic with outrage. The hon. Gentleman had the nerve to describe the Government's view of Europe as a "barren view of Europe." If anyone had wanted to listen to a barren view of Europe over the years they could have done worse than listen to speeches made by Labour Members, including the Leader of the Opposition, until recently. If we needed any lectures—and we do not, at this time of night or any other time—about the virtues of being communautaire or having a proper commitment to the European ideal, the last people to whom we would go would be Front Bench spokesmen of the Labour party.
What the hon. Gentleman described as barren was described by other hon. Members as narrow. I accept that tonight I have set out a narrow view of the issue. I have dealt with the document that is before the House, and it does not relate to immigration policy in general. It does not even relate to the question whether EC nationals should have an automatic right of abode in other countries in the Community.
It deals with amendments to principles that have been accepted in the Community for the last 20 years concerning the circumstances governing the ability of workers to travel around the Community with—in layman's terms—those dependent relatives whom they might wish to take with them. We have agreed with the Commission and said that, after 20 years, those rights may need to be uplifted. The hon. Gentleman may have thought I was being narrow, but in fact I was simply attempting to stay in order.
The hon. Gentleman went on to express surprise that I might find anything with which to sympathise in the amendment in the name of my hon. Friend the Member for Northampton, North (Mr. Marlow). One must address the underlying concerns, and I referred to them at the beginning of my remarks—underlying concerns about imprecision of language, which is in nobody's interest except that of the lawyers, along with matters relating to competence.
My hon. Friend the Member for Stafford (Mr. Cash) made an interesting point, as usual. He has considerable knowledge of the workings of Europe. He made some proposals, which amounted to saying that we might have gone down a different path from the point of view of qualified majority voting. He seemed to suggest that perhaps it was not too late even now to consider doing something about that. That is a broader point, which does not touch on the issues which concern us tonight.
I have had many dealings over the years with the hon. Member for Orkney and Shetland (Mr. Wallace) in Standing Committees on employment matters. I am never certain how the hon. Gentleman will end his remarks,

whether he will sympathise with the views of hon. Members on these Benches or on the Benches opposite. He seems to take the classic mugwump's view, in that he leaves his mug on one side of the fence and his wump on the other, and one never knows until he has finished of whom he has been speaking in favour.
The hon. Gentleman thought that there was no imprecision that mattered in the definitions about which we are talking. I disagree with him. There is a great deal of imprecision, and my hon. Friend the Member for Northampton, North referred to it. The explanatory memorandum produced by the former Minister of State states:
Workers who are Community nationals, and their spouses and dependent children and parents of any nationality, are currently allowed to live and work anywhere in the Community.
So far so good, and even my hon. Friend the Member for Northampton, North might be with me in that.
It goes on:
This right would be extended to all relatives in the ascending and descending line of the worker and spouse, whether or not dependent, and to all other relatives who are dependent on the worker or living under the same roof in the home country.
I was asked what that meant. I do not know, but I say as a lawyer that it is pregnant with possibilities. I can imagine, in a previous incarnation, doing massively well on behalf of whomever briefed me, arguing that it meant one thing or another, or both things or neither. It is in nobody's interest to have that sort of imprecision in measures that come before the House, so our business tonight is to try to ensure that imprecision of that type does not exist.
The hon. Member for Orkney and Shetland then raised a fair point relating to people who may have retired or to the dependants of people who may have died. Those moving to take up work or to set up in business, and their dependants, are given right of residence. If they stay for more than six months, they are given a resident's permit, which is renewed so long as they are working and, perhaps more to the point in view of the hon. Gentleman's concerns, they can remain with families in the host state on retirement and families can remain after the death of a worker who has worked for two years, and those rights of residence do not depend on the issue of a permit.
My hon. Friend the Member for Northampton, North made, as always, a splendid speech. I had heard it before and I am sure that, if my luck is out, I shall hear it again. He makes an old song sound fresh every time he sings it. He does something which, were I to share his views, I would do also. But I do not, so I shall not. He takes us through the situation that might arise when, as we know, such matters cannot be challenged for ultra vires in advance.
What would happen, asked my hon. Friend, if one went down all the paths of negotiation, debates in this House and finally to the court, where the wicked old Europeans, as my hon. Friend would have it, again exercised their political judgment? My hon. Friend has an honourable tradition of not liking Europe and its works, so in advancing that course, he is bound to see the very worst side all the time. The difficulty is that those of us who are committed to Europe see the advantages in the system as well—advantages in freeing up and having sensible voting systems through qualified majority voting, because at times it works in terms of 1992. It is very much a matter


of taking the rough with the smooth, but from my hon. Friend's point of view, there is never any smoothness in respect of Europe—it is roughness all the way.

Mr. Marlow: If my hon. Friend does not mind my correcting him, he has got it wrong. I am in favour of Europe, but unto the Europeans that which is Europe's and unto the United Kingdom and the sovereign territories of Europe that which should be their sovereign matters. We have the Single European Act, and we all understand that there is agreed majority voting on the single market. What we are rightly concerned about and what I wish my hon. Friend would be concerned about is the creeping competence of the European Community. It is trying to gain majority voting competence over issues and areas that we never contemplated would be controlled in that way.

Mr. Nicholls: I assure my hon. Friend that I understood that that was his position. He said that it was never intended under the Single European Act that, for example, immigration questions should be brought within the Community's competence. To some extent, it depends on the way that one uses the language. My hon. Friend may see this as primarily an immigration matter; I see it more prosaically, as no more than a recognition that, if there is to be freedom of movement of workers within a common market, it seems to make sense logically and morally to allow them to take their dependent relatives with them. Whether the term "dependent relatives" should be extended widely is another matter.
I accept the point that the hon. Member for Greenock and Port Glasgow (Dr. Godman) made about section 14 of the Merchant Shipping Act 1988. I hope that he will accept that, at this time of night, I should write to him about that matter, rather than try to deal with it at the Dispatch Box.

Question put and agreed to.

Resolved,
That this House takes note of European Community Document No. 5786/89 relating to freedom of movement for workers; supports the broad objective of free movement for workers within the Single Market; and endorses the Government's intention of seeking amendment of inappropriate provisions.

EUROPEAN COMMUNITY DOCUMENTS

Motion made, and Question put forthwith pursuant to Standing Order No. 102(5) (Standing Committees on European Community documents).

WASTE

That this House takes note of European Community Document No. 8066/88 relating to waste; and supports the Government's intention to seek to ensure that the provisions of these Directives are necessary to protect human health and the environment from the danger arising out of waste disposal.—[Mr. Sackville.]

Question agreed to.

STATUTORY INSTRUMENTS, &c.

Motion made, and Question put forthwith pursuant to Standing Order No. 101(5) (Standing Committees on Statutory Instruments, &amp;c.)

HOVERCRAFT

That the draft Hovercraft (Application of Enactments) Order 1989, which was laid before this House on 22nd June, be approved.—[Mr. Sackville.]

Question agreed to.

NORTHERN IRELAND

That the draft Appropriation (No. 3) (Northern Ireland) Order 1989, which was laid before this House on 29th June, be approved.—[Mr. Sackville.]

Question agreed to.

REPRESENTATION OF THE PEOPLE

That the draft Representation of the People (Northern Ireland) (Amendment) Regulations 1989, which were laid before this House on 6th July, be approved.—[Mr. Sackville.]

Question agreed to.

HOUSE OF COMMONS (SERVICES)

Ordered,
That Mr. Trist an Garel-Jones and Mr. David Hunt be discharged from the Select Committee on House of Commons (Services) and Mr. Alistair Goodlad and Mr. David Lightbown be added to the Committee.—[Mr.Saclville.]

PETITIONS

NHS Reform

Mrs. Alice Mahon: I beg to ask leave to present a petition containing 5,500 signatures. It represents the voice of the people of Yorkshire and Humberside telling the Government of their fears for the future of the National Health Service. They have reached the clear and logical conclusion that, if their NHS hospitals are set up as hospital trusts and become businesses with information systems, giving the costs of every treatment in detail, and can borrow money in the City, set their own wage rates and hire and fire staff at will, they are set for total privatisation, and the people want none of it. The Government should listen to their voice.
The petition states:
To the Honourable the Commons of the United Kingdom of Great Britain and Northern Ireland in Parliament assembled. The humble petition of the people of Yorkshire and Humberside showeth that they are opposed to the Government NHS White Paper proposals, particularly on the opting out of local hospitals.
Wherefore your Petitioners pray that your honourable house does not approve these proposals and maintains the NHS as a truly national service. And your Petitioners, as in duty bound, will ever pray, etc.

To lie upon the Table.

Mr. David Hinchliffe: The petition which I wish to present to the House has been organised by members of the National Union of Public Employees and signed by about 5,500 people from various parts of Yorkshire and Humberside who oppose the proposals that are contained in the White Paper on the National Health Service. The petitioners believe that the Government are effectively breaking up the NHS by proposing to allow the formation of independent hospital trusts whereby individual hospitals, or health units, opt out of local health authority control. They are concerned that the setting up of a series of separate, individual competing units will result in the ending of the comprehensive nature of Britain's health care and believe that it is nonsense to introduce a system whereby the health provision and treatment available in any locality will be dependent upon the business acumen of individual health managers.
The petitioners are worried that the proposals in the White Paper are part of a longer-term plan to pave the way for health care provision that is based entirely on market forces. They stand by the original principles of an NHS based on need and not ability to pay. Accordingly, they urge the House to reject the White Paper in its entirety. I am happy entirely to endorse their wishes and concerns.
The petition states:
To the honourable the Commons of the United Kingdom of Great Britain and Northern Ireland in Parliament assembled. The humble Petition of the People of Yorkshire and Humberside showeth that they are opposed to the Government NHS White Paper proposals, particularly on the opting out of local hospitals.
Wherefore your Petitioners pray that your honourable House does not approve these proposals and maintains the NHS as a truly national service.
And your Petitioners, as in duty bound, will ever pray.

To lie upon the Table.

Health Service (Cornwall)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Sackville.]

Mr. Matthew Taylor: I welcome this opportunity to express my concern about the conditions and future of the National Health Service in Cornwall. I thank the Under-Secretary of State for being in his place in the early hours of the morning to respond to my concerns. The hon. Gentleman is most welcome. It is not always easy to wait for other debates to finish, to wonder what time we shall finish and to keep awake. I make no apology for holding the Minister here, however, because I believe that health is of immeasurable concern to my constituents. The Health Service is the issue on which I have received the largest post bag in recent months.
It is sad that people nationwide, but especially in Cornwall, have grown to expect the problems that are associated with long waiting lists. Despite considerable investment in the county, which I acknowledge and welcome, we have failed to keep pace with growing needs. Cuts have been made, but not as a result of a rational examination of the county's health needs. Instead, they have been the result of an immediate cash crisis. Even now, we are concerned about the future of the Tehidy hospital and the possible privatisation of St. Mary's hospital within that context.
The publication of the White Paper, with proposals for general practitioners' contracts, has horrified people as never before. The concern of many Cornish doctors centre around the likelihood that the proposals outlined in the White Paper, especially on the proposed doctor's contract, will be detrimental to the welfare of rural practices in particular and to the people whom they seek to serve.
The purpose of the document appears to be to increase competition between the providers of health care in the hope that this will mean a better service and the better use of resources. Unfortunately, for the people of Cornwall, the Government are so certain in their faith that competition is the answer to everything that they have seemingly failed to assess the effects of their policy on different and peculiar parts of the country. People who are ill are not interested so much in having the right to exercise choice about the form of treatment that they will receive and which hospital they will attend. Instead, they want confidently to expect that they can rely on receiving quality care when they need it and within easy access of their home.
In my view, the current proposals could all too often mean no choice at all. The Secretary of State, when defending the reforms in early May, recommended a study of the magazine entitled Medeconomics. I am glad that I took the trouble to follow his advice. I found that those who write for the magazine had examined a small rural practice in the south-west which is based in Constantine in Cornwall. The article looked at the proposed changes, and in its conclusions said:
Unfortunately, there seems to be little scope for these GPs to increase their income. The isolated areas in which they work means that outside appointments are difficult to come by. The GPs have none. The list is a stable one biased towards a higher than average proportion of elderly patients and there is little prospect of change.
Once the GPs know how their remuneration package will change, they will need to take careful stock of their position.


If economic realities prove harsh in the future, they should not overlook the possibility of eventually ending the practice and joining partnerships in a more populated part of the country.
In other words, the magazine, which I read at the recommendation of the Secretary of State, says that they may have to give up. That is a practice that has been referred to me by doctors in Cornwall as an example of best practice and of the kind of service that other doctors would ideally like to offer to their patients.
The doctors' contract will have a devastating effect on rural health care. The measures to tie the level of pay to list sizes and the reduction in basic practice allowance will not benefit rural doctors, but will penalise them in order to offer incentives to busier practices in wealthier areas. In many practices in Cornwall, it will be impossible for doctors to acquire more patients, leaving practices either financially untenable or at least less attractive. What kind of choice is that for those for whom it is their only source of health care for many miles? Unlike the views of Conservative think tanks, competition as such is far from central to rural patients' hopes for the NHS. How many areas have different practices with easy access between which a choice can be made? How many areas have a range of hospitals which doctors can play off against each other?
The reforms for rural practices appear to run counter to the Government's expressed aims. Rewards for larger list sizes puts in to reverse the attempts by successive Governments of all parties to encourage GPs to take fewer patients on to their lists so as to improve individual care. How can preventive medicine truly be encouraged, when it is best achieved with a small list size and time with the patient? In the rural areas of the south west, the distance between split-site surgeries, the difficulties that the patients have with transport and the travelling time required to visit patients are all real problems that the Government have singularly failed, as yet, properly to address.
A poll conducted by the Cornwall and Isles of Scilly local medical committee found that 98 per cent. of patients registered with GPs in Cornwall think that there will be little or no improvement in patient care following the changes proposed in the White Paper. Incidentally, 96 per cent. view it as nothing but a cost-cutting exercise. Not only are patients disaffected with the Government's proposals, but all the polls show that the very people who are expected to implement them are also overwhelmingly against them. The result of the ballot of GPs announced last week was a clear indictment of the new GPs' contract devised by the Government. At a meeting of the Cornwall division of the BMA in April, the White Paper was also overwhelmingly rejected.
My experience of meetings with GPs has shown to me their overwhelming condemnation of the Government's proposals. I believe that that condemnation springs not out of interest in their wallets, as the Secretary of State has tried to suggest, but out of concern about the impact that they will have on the treatment of patients. Indeed, at the meeting organised by the BMA in Plymouth, which I attended, I witnessed the most unexpected sight of a doctor breaking down in tears over the proposals, when he tried to ask a question. It shook the Conservative Member of Parliament, who had been asked by the Secretary of State to attend that meeting and defend the proposals, as much as it shook everyone else in the audience.
Many of the doctors and patients who are now protesting so vehemently are people who have told me that they have voted Tory all their lives. They have been driven to the point of condemning their Government, because they are so acutely aware of the vital services that rural practices and hospitals offer and of the vulnerability of the situation in which such practices and hospitals now find themselves.
I wish to take the opportunity to call on the Minister, together with his colleagues, to publish immediately a paper on the future of rural doctors, detailing how the proposals will affect them. I look forward to hearing specific comments from the Minister in response to the points that I have made on this. At the very least, it must be clear from what I have said that Ministers have yet to prove their case. They have failed to convince any of those involved that there are not major pitfalls in the proposed reforms. One wonders why, at the very least, the reforms cannot be tried out experimentally in a few districts before being imposed on them all.
I ask the Minister to comment also on the position of GPs who spend much of their working week in community hospitals. Will that time be included in the number of hours that GPs are required to be available in their surgeries? The Minister is well aware of my concern on this point. Indeed, the Minister's recent response to me on this subject seems to hold the clear suggestion that at least at the margin there will be financial penalties for engaging in community hospital work. Those community hospitals are considered to be of great importance by many of my constituents. I hope that the Minister will be able to find ways to protect their position.
I turn now to the crippling problem of lengthy waiting lists. At the end of March this year the waiting list in Cornwall for orthopaedics was 1,207 for in-patients, of whom 434 had been waiting more than a year for treatment; a further 231 were waiting for care as day-patients. In general surgery, a total of 1,768 people were waiting to go into hospital and 1,264 were waiting for day care; 459 people had waited more than a year for in-patient treatment and 224 were waiting for out-patient treatment. Those figures are poor, as are the figures for the number of consultants per patient in the county. I do not believe that the Government's current plans will reduce those waiting times.
How, in practice, can people be sent to another hospital with a shorter waiting list without at the very least breaking their contact with their own community and with their friends and relatives when there is only one main hospital in the whole county? The Government may well conjure up a way of doing so by forcing on doctors, through practice budgets, the task of limiting the numbers treated. However, that does nothing for patients who want treatment. It does not speed things up; it simply disguises the problem. It breaks down the trust between GP and patient as the useful alliance between GP and patient in attempting to get treatment turns to a relationship in which the patient cannot be sure whether the doctor who says, "You do not need treatment just now," is thinking of the practice's accounts or of the patient's needs. That will be intolerable for patients on a waiting list and it should be unacceptable to all of us.
The Government have an opportunity to do something about this matter and to instil some hope in those who had begun to despair of the situation ever improving. Cornwall district health authority has bid for two extra posts of the


100 extra consultant posts that the Government have said that they will provide for the whole country. If granted, they could well lead to a reduction in the waiting list and I implore the Government to meet their request. We need more specialist staff.
Ministers and the Department acknowledge that we have special difficulties and needs at present. Like it or not, those problems come down to the level of funding and the provision of staff and, as I have said, the opportunity to improve things is there.
A specific issue concerning funding for the Cornwall health authority is the issue to which I turn next. Cornwall health authority is an unusual position in that it does not currently receive the total funds due for its population. Some of this funding due to Cornwall goes instead to north Devon and to Plymouth. This is because of the area known as the overlap, where people in Cornwall use Plymouth and north Devon hospitals and facilities for acute services. Cornwall does, however, provide these people with community health care and for the needs of the handicapped and elderly. I would hope that all the funding due to Cornish people would now go to Cornwall as it does to other areas in similar situations. This is probably worth an extra £17 million, which currently goes to Plymouth health authority. The Cornwall health authority can then purchase services from Plymouth and north Devon hospitals for the overlap area, as happens elsewhere. More comprehensive packages of service can be possible if Cornwall health authority has responsibility for all the various aspects of its health care. I ask the Minister for an assurance that Cornwall be fully funded for its total resident population.
A final issue, and one of much local concern, is the funding of our air ambulance. Cornwall has the first air ambulance in the country, which receives no Government funding. The generosity of the Cornish people is fulfilling what should be the role of central Government in providing necessary health services. I have pressed the need to take account of the special costs of providing transport services in a rural scattered area. The advantages of an air ambulance in providing such services are considerable. It can reach geographically isolated areas rapidly and areas not served by land ambulances, even as far as the Isles of Scilly. The journey back time can be much shorter than that of a land ambulance. More importantly, it is a highly mobile resource which can be moved, around the county to stand back-up for an area when land ambulances are fully committed.
In a geographically large area, even one land ambulance called to an accident can leave a vast part of the county without effective ambulance cover. The air ambulance is uniquely able to prevent that. If the Minister doubts that, I recommend that he looks at the map on the wall of the Truro ambulance station to see just how wide an area one ambulance may have to cover at any one time, particularly in north Cornwall.
Added to those basic principles is the fact that it appears to have a proven record of success. When the air ambulance is available, the response to emergencies within 20 minutes is 95 per cent. but only 90 per cent. when it is not available. Thus the Government target of 95 per cent. response rate within 20 minutes is met only with the air ambulance in operation.
Currently it costs £22,000 a month to fund the air ambulance. That is cost-effective as, although the cost is equivalent to that of seven land ambulances, it would take

17 to provide the same level of back-up due to the distances involved. It is a vital and unique experiment in the provision of health care in a rural scattered area. It is unique in this country and the first figures seem to demonstrate that it is a success—it is saving lives.
So why is it that a service which has proved so necessary should have to live with the uncertainty that arises from being dependent on donations by the general public however generous they may be? The Government should respond to the generosity of the Cornish people who have given so much to this scheme by recognising this and agreeing to provide funding themselves. Extra financial allowances have to be made for the transport difficulties of a long rural area surrounded by sea, yet I understand that Government funding is being provided for the London air ambulance rather than the Cornish one.
Currently, an evaluation of air ambulance services has been proposed by Ministers, but so far, although I have pressed for Cornwall to form an essential part of it, Ministers have been reluctant, partly on cash grounds. Yet Cornwall has a unique service. I would welcome at least an initial commitment by the Minister to find funds for an independent evaluation of the Cornwall air ambulance. I hope that he can make that promise tonight.
If, once again, funding is refused, Cornwall will conclude that the Government have no interest whatsoever in this innovative method of improving health care in rural areas. I repeat tonight an invitation I have made before. Will the Minister agree to come as my guest to see the service offered from Truro?
I have outlined some of the issues on which I would like a specific response from the Minister. I contacted his offices and spoke to him earlier today to give him the opportunity to examine some of the issues that I hoped to raise. I look forward to his reply and I hope that he will offer a message of encouragement and a promise of Government action that I can take back to my constituency.
There is great advantage in having had the opportunity of the debate and I am grateful for that. At the very least I know that the Minister and his civil servants have taken a special look at the needs of the county. I hope that in future when they examine the needs of the Health Service in Cornwall they will remember some of the things that they have heard tonight.

The Parliamentary-Under Secretary of State for Health (Mr. Roger Freeman): I congratulate the hon. Member for Truro (Mr. Taylor) on securing time for this Adjournment debate on the Health Service in Cornwall, in which he has always shown a keen interest. I also note that my hon. Friend the Member for St. Ives (Mr. Harris) is in his place. He also takes an extremely close interest in health care in his county.
The subject is wide, and I hope that I shall be able to deal with all the points that the hon. Member for Truro raised. I thank him for his courteous opening remarks and for forewarning me of some of the issues that he would raise.
It is as well to start with a general overview of the way in which things have improved recently. Cornwall and Isles of Scilly comes under the purview of the South Western regional health authority, which is responsible for the allocation of resources, for approving districts'


programmess and for reviewing their performance. Cornwall figures large in the region's plans. The district general hospital at Treliske, which is in the hon. Gentleman's constituency, is subject to major capital development. Phase 4 is under construction at a cost of more than £8 million, and a further phase is planned. A new acute geriatric assessment unit has been approved for the West Cornwall hospital in Penzance at a cost of £2 million.
On revenue, Cornwall is the second highest spender in the region, with an allocation of nearly £98 million for 1989–90, which is a real-terms increase of about 2 per cent. over the previous year. Since 1978–79, the region's recurrent resources are expected to have risen by about 35 per cent. in real terms, and Cornwall has benefited from these large injections of cash. Cornwall has also managed to release more than £4 million in its cost improvement programmes cumulatively during the past three years for use in developing and improving services. I congratulate it on that achievement.
All these extra resources have fed through into additional services by more patients being seen in better accommodation. The number of nurses, doctors and other front-line staff has risen steadily, as has their proportion. Patient activity has continued to grow. In-patient, out-patient and day care activity have all risen significantly.
These figures are evidence of substantial improvements to health services in Cornwall recently, as I am sure the hon. Gentleman will acknowledge. In spite of the significantly increased number of patients who are being seen and treated, however, waiting lists have grown. The hon. Gentleman gave some statistics, and I do not disagree with the impression that he has given the House. We have recognised the problem, as has the region and the district. That is why Cornwall and Isles of Scilly was one of the 22 districts which this year received special attention from an independent management team to help find a way in which to reverse the trend.
The waiting lists are no reflection on the hard work put in by Cornwall's consultants; they are simply an expression of demand rising even faster than available resources and improvements in efficiency can match. To help ease the pressure, I understand that the district has put in a bid for two of the 100 additional consultants who were promised by my right hon. and learned Friend the Secretary of State when he launched the White Paper "Working for Patients". All regions in England have been asked to submit bids for additional consultants by the end of this month. My Department will then assess priorities with the steering group on "Achieving a Balance", and we aim to make an announcement in October.
Meanwhile, I understand that the district will add a new consultant post in urology to its staff in September. During the past three years, Cornwall has been allocated more than £450,000 from the waiting list fund which, by the end of this year, will have been used to treat some 3,000 additional in-patients and day cases.
Among the many local initiatives, I am impressed by the success of Cornwall's first air ambulance service in terms of public support. It has caught the imagination of the public, who have responded magnificently with financial support. However, I must resist the hon.

Gentleman's specific call for special funding for the service. It is a local initiative and a local service, and it is therefore a matter to be handled by the health authority. However, I am examining the possibility of some help in evaluating the service, in which there will be wider interest. I expect to reach a conclusion on that in due course and I shall ensure that I write not only to the hon. Gentleman, but to my hon. Friend the Member for St. Ives, who I am sure has an interest in the subject.
The hon. Gentleman raised the subject of community hospitals and general practitioners.

Mr. Matthew Taylor: Before the Minister moves on, I must say that over the past 18 months, I have repeatedly tried to get a Minister to come down to have a look at the authority. Perhaps this is the moment for the Minister to agree to do that.

Mr. Freeman: I am trying to answer the points raised in the debate. I very much regret that I cannot commit myself to visiting the authority in the near future. I very much hope that I shall be able to do so at the appropriate time.
I was referring to community hospitals and the responsibilities of general practitioners towards those hospitals. General practitioners spend part of their time working for community hospitals. They are paid for that valuable service and we all recognise how important that is. However, we believe that, if general practitioners are to work full time, they must be available for 26 hours over five days a week and that includes surgery consultations, clinics and home visits.
As I hope I have made clear to the hon. Gentleman in the form of a recent letter, and as I want to put on the record now, where those general practitioners are working in community hospitals—I recognise their importance, especially in the rural areas—we believe that they should apply to their family practitioner committees for a waiver of the five-day requirement, so that they can spread their commitment of 26 hours a week over four rather than five days. I hope that the hon. Gentleman will find that a constructive comment.
The hon. Gentleman also raised questions about the general practitioners' proposed contract, especially for rural areas. I want to deal first with rural practice payments, to which the hon. Gentleman referred. The payments recompense the general practitioners for the additional time and expense that might be incurred in caring for patients in rural areas. The main criterion for payment is, briefly, that at least 10 per cent. of patients on the general practitioner's list are resident in his or her rural practice area and live at least three miles from the main surgery. Each of those patients attracts units of monetary value depending on the distance and difficulty in reaching him or her.
Earlier this year, we agreed with the General Medical Services Committee that the special nature of practice in truly rural areas should continue to be recognised in the system of fees and allowances. We also agreed that the current scheme was not as well targeted as it could be. The whole question of payment to general practitioners in rural areas in England, such as Cornwall, is therefore being referred to the central advisory committee on rural practice payments. That is what the doctors' leaders wanted and we are considering how to carry this forward. Meanwhile, the current scheme will continue in operation.
The hon. Gentleman implied that general practitioners and some of their patients are in great turmoil. I believe that general practitioners should await not only the proposed contract, which must be laid before Parliament—and will he in the autumn—but more importantly, the report of the doctors' and dentists' review body, which must price the contract. I hope that I can deliver a message on the contract through you, Mr. Deputy Speaker, to the doctors of Cornwall tonight. My message is that they should wait and consider what action they feel they must take in the light not only of the contract, but of our conclusions on rural practice payments and the doctors' and dentists' review body. Doctors will then be able to reach rational judgments on whether they should change their practices, particularly their working practices, and the size of their patient lists.
We understand that doctors in rural areas will have smaller lists. It is very difficult for patients to change doctors. It is not the Government's intention to frustrate

the provision of general practice service to patients in rural and scattered areas. We want to improve the quality and quantity of that service.
I welcome the hon. Gentleman's implied support for our funding proposals and also for contracts. Following the Resource Allocation Working Group, we will fund districts such as Cornwall and the Isles of Scilly on the basis of residence in the district. It will then be up to the health authority, through the medium of contracts. to pay for the provision of services outside districts such as Plymouth. We believe that that will be a fairer and more flexible system. The hon. Gentleman and my hon. Friend the Member for St. Ives will join me in welcoming the aim of the White Paper, if not the specific proposals, and the doctors' contract—to improve the quantity and quality of health care, not only in Cornwall but in England as a whole.

Question put and agreed to.

Adjourned accordingly at twenty-five minutes to Two o'clock.